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Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC)

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Abstract

Purpose: Ovarian failure and infertility following adjuvant chemotherapy for early breast cancer are major concerns for some young women. Techniques for oocyte harvesting are associated with delay in starting treatment, potentially undesirable estrogen stimulation and a relatively low success rate. We report an audit of our experience with the luteinising hormone-releasing hormone agonist, goserelin, to achieve transient ovarian suppression during chemotherapy as a means of preserving ovarian function. Patient and methods: Pre-menopausal women were offered goserelin 3.6 mg by subcutaneous injection every 28 days during chemotherapy, starting 0–14 days prior to treatment. The primary end-point was recovery of menstruation. Serum luteinising hormone, follicle stimulating hormone and oestradiol were measured at recovery of menstruation or at first year follow-up if amenorrhoea persisted. Subsequent pregnancies were recorded. Results: Fifty-one evaluable women were audited. Amenorrhoea occurred in all but one. All received combination anthracycline-containing chemotherapy regimens with a mean cumulative cyclophosphamide dose of 3.9 g/m2. Forty-five (90%) recovered menstruation during the first year of follow-up; mean time to recovery 5 months. Eight pregnancies in 10 women attempting this so far. Conclusion: Using goserelin concurrently with chemotherapy is associated with a high rate of ovarian function preservation.

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Acknowledgements

Dr Monica Arnedos would like to thank the Cridlan Fund for allowing her to be part of this project.

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Authors and Affiliations

  1. Institut Catala d’Oncologia, Hospital Duran i Reynalds, Gran Via km 2.7. L’Hospitalet de Llobregat, Barcelona, Spain

    Ander Urruticoechea

  2. Breast Unit, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK

    Monica Arnedos, Geraldine Walsh, Mitch Dowsett & Ian E. Smith

  3. Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK

    Mitch Dowsett & Ian E. Smith

Authors
  1. Ander Urruticoechea
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  2. Monica Arnedos
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  3. Geraldine Walsh
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  4. Mitch Dowsett
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  5. Ian E. Smith
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Correspondence to Ian E. Smith.

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Urruticoechea, A., Arnedos, M., Walsh, G. et al. Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC). Breast Cancer Res Treat 110, 411–416 (2008). https://doi.org/10.1007/s10549-007-9745-y

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  • DOI: https://doi.org/10.1007/s10549-007-9745-y

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