Fertility and adjuvant treatment in young women with breast cancer (original) (raw)

Fertility preservation in women with breast cancer

2010

Fertility preservation is an important issue for young women diagnosed with breast cancer. The most well-established options for fertility preservation in cancer patients, embryo and oocyte cryopreservation, have not been traditionally offered to breast cancer patients as estradiol rise during standard stimulation protocols may not be safe for those patients. Potentially safer stimulation protocols using tamoxifen and aromatase inhibitors induce lower levels of estradiol while similar results in terms of number of oocyte and embryo obtained to standard protocols. Cryopreservation of immature oocytes and ovarian cortical tissue, both still experimental methods, are also fertility preservation options for breast cancer patients.

Management of young women with early breast cancer – focus on fertility preservation

Libri oncologici, 2019

Management of young women with breast cancer is complex and has several particularities, one of which is fertility preservation, a very important quality of life issue for young breast cancer survivors. Chemotherapy can be gonadotoxic and signifi cantly reduce woman`s reproductive potential and cause premature ovarian insuffi ciency while endocrine therapy requires a delay of pregnancy and indirectly aff ects fertility. Therefore every woman of reproductive age diagnosed with breast cancer should be informed about potential gonadotoxic eff ect of cancer treatment, the risk of premature ovarian insuffi ciency and associated symptoms, available fertility preservation methods, delay of cancer treatment and chances of subsequent pregnancy. If interested in fertility preservation breast cancer patients should be referred as early as possible to a reproductive specialist to further discuss the risk of infertility and available fertility preservation options. Currently established methods for fertility preservation are embryo and oocyte cryopreservation, while ovarian tissue cryopreservation, cryopreservation of immature oocytes and ovarian suppression with gonadotropin-releasing hormone agonists are still considered experimental. The aim of this review is to highlight the importance of fertility preservation as an important quality of life issue for young breast cancer survivors.

Breast cancer and fertility preservation

Fertility and Sterility, 2011

Objective-To review the benefits of adjuvant systemic therapy given to women with breast cancer of reproductive age, its effects on fertility, and options for fertility preservation. Design-Publications relevant to fertility preservation and breast cancer were identified through a PubMed database search. Conclusion(s)-Most women who develop invasive breast cancer under age 40 will be advised to undergo adjuvant chemotherapy with or without extended antihormonal therapy to reduce the risk of recurrence and death from breast cancer. Adjuvant chemotherapy particularly with alkylating agents such as cyclophosphamide is gonadotoxic and markedly accelerates the rate of age-related ovarian follicle loss. Although loss of fertility is an important issue for young cancer survivors, there is often little discussion about fertility preservation before initiation of adjuvant therapy. Greater familiarity with prognosis and effects of different types of adjuvant therapy on the part of infertility specialists and fertility preservation options such cryopreservation of embryos, oocytes, and ovarian tissue on the part of oncologists would facilitate these discussions. Establishment of rapid fertility consultation links within cancer survivorship programs can help ensure that every young woman who is likely to undergo gonadotoxic cancer treatment is counseled about the effects of therapy and options available to her to increase the likelihood of childbearing after cancer treatment.

The current multidisciplinary approach to fertility preservation for breast cancer patients

The Breast, 2017

B reast cancer is one of the most common cancers affecting women worldwide. Thousands of young women are diagnosed with breast cancer every year [1 , 2]. Over the past four decades as diagnostic and treatment strategies (including surgery, irradiation and systemic therapy) have improved, the long-term outcomes of breast cancer patients have also improved [3]. Many patients with breast cancer can thus expect to live for many more years, and this progress raises important of quality-of-life issues such as fertility, which is particularly important for younger breast cancer patients [4 , 5]. Certain treatments for breast cancer, including chemotherapy and endocrine therapy, may adversely affect fertility [1 , 6]. Breast cancer treatment can have significant side effects including a transient or permanent impairment of gonadal function and subsequent infertility [7]. The duration of adjuvant endocrine therapy may also influence the timing of pregnancy for breast cancer patients. Five years of adjuvant endocrine therapy have traditionally been recommended, and treat-http ://escholarship.lib.okayama-u.ac.jp/amo/

Fertility conservation in breast cancer patients

Women's Health, 2011

Breast cancer is the most common malignant tumor in women. Increasing survival rates after breast cancer, new reproductive techniques and growing interest regarding the quality of life after cancer have brought the possibilities of fertility-preserving treatment to the center of attention of oncologists and affected patients. Many of these women suffer from infertility and premature menopause as a result of chemotherapy. Several measures, for example gonadotropin-releasing hormone analogs, hormonal stimulation to cryopreserve oocytes, ovarian tissue cryoconservation or a combination of the methods, can be undertaken depending on the hormone receptor status of the tumor, and the patient's age and partner status. Embryo cryopreservation is currently the most promising fertility preservation option. Early counseling on fertility-preserving strategies is of utmost importance, so that the fertility-preserving method can be integrated into the oncologic therapy regime.

Practical consensus recommendations on fertility preservation in patients with breast cancer

South Asian Journal of Cancer

Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Expert oncologists along with reproductive medicine specialists discuss fertility preservation options in this chapter since fertility preservation is becoming a priority for young women with breast cancer. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.