Introduction We aim to identify patients‘ knowledge about their future fertility and reproductive health at the time of breast cancer surgery in order to adapt the preoperative patients’ counselling.

Methods This is a single-institution cross-sectional observational study based on in person interview with an Arabic questionnaire to collect quantitative and qualitative data from a cohort of young women diagnosed with breast cancer before the age of 40 between January 2022 and February 2023. All interviews took place within a month prior to the breast cancer surgery in patients that had no neoadjuvant treatment.

Results A total of 48 women took part in the study. The mean age of the patients was 35 [24–40]. Of the 18 married participants, 10 were childless. Fertility was not a spontaneous concern reported by women when asked about their greastest fears before breast surgery. Among the single participants, 80% think that their cancer will be an obstacle to and/or delay their marital project. Among the participants, 31.2% fear a negative impact on their fertility due to a delay to conceive related to the prescription of contraception. 20.8% were aware of the possibility of fertility preservation but had no information about the availability of such options for them. The main concerns raised by the possibility of fertility preservation were the delay of cancer treatment (93.7%), the safety regarding the recurrence and/or flare up of their cancer (95.8%).

Conclusion/Implications Before breast cancer surgery, reproductive health and potential fertility issues are not spontaneously expressed by patients but are present in their minds.