Management of fertility preservation in young breast cancer patients in a large breast cancer centre
- 220 Downloads
The increase of breast cancer in young women under 40 years and the increasing age of women at the time of the birth of their first child underlines the importance to implement counselling for fertility-preserving strategies in the management of breast cancer care. We present the fertility-preserving procedures performed after routine counselling for primary breast cancer patients in a large certified breast cancer centre.
Materials and methods
Since November 2006, patients aged below 40 years with histologically confirmed breast cancer are routinely counselled on fertility-preserving possibilities before breast surgery and chemotherapy in the fertility centre of the University Women’s Hospital in Tuebingen. The recommendations are based on the treatment recommendations of the network FertiPROTEKT.
During the last 40 months, 56 primary breast cancer patients were counselled. Forty-one of these patients were hormone receptor positive. Thirty-four patients (63%) underwent fertility-preserving strategies. The majority of the patients (n = 22) decided on ovarian tissue cryopreservation. GnRH protection was performed in 14 patients. In 12 patients an ovarian stimulation protocol was initiated to cryopreserve fertilized or unfertilized oocytes. A combination of different fertility-preserving methods was performed in 12 patients.
The preservation of ovarian function and fertility are of great importance to young breast cancer patients. Counselling on fertility-preserving strategies is therefore critical in these patients and should be routinely performed.
KeywordsBreast cancer chemotherapy Fertility Fertility-preserving methods Cryopreservation
Cyclophosphamide, methotrexate, fluorouracil
Fluorouracil, epirubicin, cyclophosphamide
Fluorouracil, adriamycin, cyclophosphamide
We are greatly indebted to Mrs. Elizabeth Kraemer for reviewing our manuscript.
Conflict of interest statement
We declare that we have no conflict of interest.
- 1.Krebs in Deutschland (2004) 4. überarbeitet, aktualisierte Ausgabe. Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland. SaarbrückenGoogle Scholar
- 11.Ismail-Khan R, Minton S, Cox C, Sims I, Lacevic M et al (2008) Preservation of ovarian function in young women treated with neoadjuvant chemotherapy for breast cancer: a randomized trial using the GnRH agonist (triptorelin) during chemotherapy. J Clin Oncol 26(suppl):524 (abstract)Google Scholar
- 12.Gerber B (2009) ASCO Annual Meeting. ZORO: a prospective randomized multicenter study to prevent chemotherapy-induced ovarian failure with the GnRH-agonist goserelin in young hormone-insensitive breast cancer patients receiving anthracycline containing (neo-)adjuvant chemotherapy (GBG37) 526 (abstract)Google Scholar
- 15.Donnez J, Dolmans MM, Demylle D, Jadoul P, Pirard C, Squifflet J, Martinez-Madrid B, Van Langendonckt A (2006) Restoration of ovarian function after orthotopic (intraovarian and periovarian) transplantation of cryopreserved ovarian tissue in a woman treated by bone marrow transplantation for sickle cell anaemia: case report. Hum Reprod 21:183–188CrossRefPubMedGoogle Scholar
- 19.Demeestere I, Simon P, Buxant F, Robin V, Fernandez SA, Centner J, Delbaere A, Englert Y (2006) Ovarian function and spontaneous pregnancy after combined heterotopic and orthotopic cryopreserved ovarian tissue transplantation in a patient previously treated with bone marrow transplantation: case report. Hum Reprod 21:2010–2014CrossRefPubMedGoogle Scholar