Skip to main content
Erschienen in: Current Oncology Reports 7/2019

01.07.2019 | Breast Cancer (B Overmoyer, Section Editor)

Issues with Fertility in Young Women with Breast Cancer

verfasst von: Nicole Christian, Mary L. Gemignani

Erschienen in: Current Oncology Reports | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

There are competing risks and benefits of cancer therapies and fertility preservation in young women with breast cancer. Here we discuss the impact of therapy on fertility, fertility preservation options, and emerging information in fertility issues for the breast cancer patient.

Recent Findings

All systemic forms of breast cancer treatment can impact future fertility. Pre-therapy fertility preservation may offer the best opportunity for future fertility. Shared decision making with the individual patient and clinical scenario is important. Early referral to a fertility specialist should be offered to young patients.

Summary

We find that fertility preservation options for young women diagnosed with breast cancer are currently available, but potentially under-utilized. We conclude that a multidisciplinary approach is necessary, with discussion of potential risks and benefits of fertility preservation options in the context of the patient’s clinical disease.
Literatur
20.
Zurück zum Zitat •• Zhao J, Liu J, Chen K, et al. What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis. Breast Cancer Res Treat. 2014;145(1):113–28. https://doi.org/10.1007/s10549-014-2914-x. A recent meta-analysis on the impact of multiple types of chemotherapy on chemotherapy-induced amenorrhea. Review and synthesis of available data.CrossRefPubMed •• Zhao J, Liu J, Chen K, et al. What lies behind chemotherapy-induced amenorrhea for breast cancer patients: a meta-analysis. Breast Cancer Res Treat. 2014;145(1):113–28. https://​doi.​org/​10.​1007/​s10549-014-2914-x. A recent meta-analysis on the impact of multiple types of chemotherapy on chemotherapy-induced amenorrhea. Review and synthesis of available data.CrossRefPubMed
28.
Zurück zum Zitat •• Francis PA, Pagani O, Fleming GF, et al. Tailoring adjuvant endocrine therapy for premenopausal breast cancer. N Engl J Med. 2018;379(2):122–37. https://doi.org/10.1056/NEJMoa1803164. Long-term follow-up of the SOFT and TEXT trials, demonstrating ovarian suppression with tamoxifen is superior to tamoxifen alone, and exemestane with ovarian suppression is superior to tamoxifen with ovarian suppression.CrossRefPubMedPubMedCentral •• Francis PA, Pagani O, Fleming GF, et al. Tailoring adjuvant endocrine therapy for premenopausal breast cancer. N Engl J Med. 2018;379(2):122–37. https://​doi.​org/​10.​1056/​NEJMoa1803164. Long-term follow-up of the SOFT and TEXT trials, demonstrating ovarian suppression with tamoxifen is superior to tamoxifen alone, and exemestane with ovarian suppression is superior to tamoxifen with ovarian suppression.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat •• Saha P, Regan MM, Pagani O, et al. Treatment efficacy, adherence, and quality of life among women younger than 35 years in the International Breast Cancer Study Group TEXT and SOFT adjuvant endocrine therapy trials. J Clin Oncol. 2017;35(27):3113–22. https://doi.org/10.1200/JCO.2016.72.0946. Young (age < 35 years) premenopausal women with ER+ cancers experience similar symptoms to tamoxifen and ovarian suppression to older women. Approximately 20% of these premenopausal patients stop recommended therapy because of symptoms.CrossRefPubMedPubMedCentral •• Saha P, Regan MM, Pagani O, et al. Treatment efficacy, adherence, and quality of life among women younger than 35 years in the International Breast Cancer Study Group TEXT and SOFT adjuvant endocrine therapy trials. J Clin Oncol. 2017;35(27):3113–22. https://​doi.​org/​10.​1200/​JCO.​2016.​72.​0946. Young (age < 35 years) premenopausal women with ER+ cancers experience similar symptoms to tamoxifen and ovarian suppression to older women. Approximately 20% of these premenopausal patients stop recommended therapy because of symptoms.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Lambertini M, Ceppi M, Poggio F, et al. Ovarian suppression using luteinizing hormone-releasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: a meta-analysis of randomized studies. Ann Oncol. 2015;26(12):mdv374. https://doi.org/10.1093/annonc/mdv374.CrossRef Lambertini M, Ceppi M, Poggio F, et al. Ovarian suppression using luteinizing hormone-releasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: a meta-analysis of randomized studies. Ann Oncol. 2015;26(12):mdv374. https://​doi.​org/​10.​1093/​annonc/​mdv374.CrossRef
35.
Zurück zum Zitat Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, et al. It’s now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study. J Clin Oncol. 2011;29(13):1670–7. https://doi.org/10.1200/JCO.2010.31.2462.CrossRefPubMed Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, et al. It’s now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study. J Clin Oncol. 2011;29(13):1670–7. https://​doi.​org/​10.​1200/​JCO.​2010.​31.​2462.CrossRefPubMed
47.
Zurück zum Zitat •• Rodriguez-Wallberg KA, Eloranta S, Krawiec K, Lissmats A, Bergh J, Liljegren A. Safety of fertility preservation in breast cancer patients in a register-based matched cohort study. Breast Cancer Res Treat. 2018;167(3):761–9. https://doi.org/10.1007/s10549-017-4555-3. A cohort/registry study that identifies fertility preservation protocols with hormone stimulation are not associated with worse oncologic outcomes compared to fertility preservation without hormone stimulation.CrossRefPubMed •• Rodriguez-Wallberg KA, Eloranta S, Krawiec K, Lissmats A, Bergh J, Liljegren A. Safety of fertility preservation in breast cancer patients in a register-based matched cohort study. Breast Cancer Res Treat. 2018;167(3):761–9. https://​doi.​org/​10.​1007/​s10549-017-4555-3. A cohort/registry study that identifies fertility preservation protocols with hormone stimulation are not associated with worse oncologic outcomes compared to fertility preservation without hormone stimulation.CrossRefPubMed
48.
Zurück zum Zitat •• Rodgers RJ, Reid GD, Koch J, et al. The safety and efficacy of controlled ovarian hyperstimulation for fertility preservation in women with early breast cancer: a systematic review. Hum Reprod. 2017;32(5):1033–45. https://doi.org/10.1093/humrep/dex027. A meta-analysis of the literature which did not find differences in disease-specific recurrence and survival for patients undergoing ovarian hyperstimulation compared to those who did not for fertility preservation.CrossRefPubMed •• Rodgers RJ, Reid GD, Koch J, et al. The safety and efficacy of controlled ovarian hyperstimulation for fertility preservation in women with early breast cancer: a systematic review. Hum Reprod. 2017;32(5):1033–45. https://​doi.​org/​10.​1093/​humrep/​dex027. A meta-analysis of the literature which did not find differences in disease-specific recurrence and survival for patients undergoing ovarian hyperstimulation compared to those who did not for fertility preservation.CrossRefPubMed
52.
Zurück zum Zitat •• Derks-Smeets IAP, de Die-Smulders CEM, Mackens S, et al. Hereditary breast and ovarian cancer and reproduction: an observational study on the suitability of preimplantation genetic diagnosis for both asymptomatic carriers and breast cancer survivors. Breast Cancer Res Treat. 2014;145(3):673–81. https://doi.org/10.1007/s10549-014-2951-5. An observational study on the effectiveness of pre-implantation genetic diagnosis for a cohort of BRCA mutation carriers, and results of successful pregnancies.CrossRefPubMed •• Derks-Smeets IAP, de Die-Smulders CEM, Mackens S, et al. Hereditary breast and ovarian cancer and reproduction: an observational study on the suitability of preimplantation genetic diagnosis for both asymptomatic carriers and breast cancer survivors. Breast Cancer Res Treat. 2014;145(3):673–81. https://​doi.​org/​10.​1007/​s10549-014-2951-5. An observational study on the effectiveness of pre-implantation genetic diagnosis for a cohort of BRCA mutation carriers, and results of successful pregnancies.CrossRefPubMed
Metadaten
Titel
Issues with Fertility in Young Women with Breast Cancer
verfasst von
Nicole Christian
Mary L. Gemignani
Publikationsdatum
01.07.2019
Verlag
Springer US
Erschienen in
Current Oncology Reports / Ausgabe 7/2019
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-019-0812-4

Weitere Artikel der Ausgabe 7/2019

Current Oncology Reports 7/2019 Zur Ausgabe

Geriatric Oncology (AR MacKenzie, Section Editor)

Management of Newly Diagnosed Elderly Multiple Myeloma Patients

Neuro-oncology (Y Umemura, Section Editor)

Targeted Therapies for the Treatment of Glioblastoma in Adults

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Das sind die führenden Symptome junger Darmkrebspatienten

Darmkrebserkrankungen in jüngeren Jahren sind ein zunehmendes Problem, das häufig längere Zeit übersehen wird, gerade weil die Patienten noch nicht alt sind. Welche Anzeichen Ärzte stutzig machen sollten, hat eine Metaanalyse herausgearbeitet.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.