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Fertility preservation does not delay the initiation of chemotherapy in breast cancer patients treated with adjuvant or neo-adjuvant chemotherapy

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Abstract

Purpose

To investigate whether fertility preservation (FP) in adult women diagnosed with breast cancer (BC) may impact the time interval between diagnosis and start of chemotherapy in an adjuvant or neo-adjuvant setting.

Methods

Retrospective cohort study of breast cancer patients diagnosed between January 2012 and December 2017 undergoing FP at a tertiary-care academic fertility centre before neo-adjuvant (NAC) or adjuvant chemotherapy (AC), and matched control breast cancer patients who had no FP. FP interventions included oocyte vitrification following ovarian stimulation or after in-vitro maturation (IVM) of immature oocytes, and/or ovarian tissue cryopreservation. Controls from the patient database of the affiliated Breast Cancer Clinic were matched for tumour characteristics and type of treatment. Time intervals between cancer diagnosis and the start of chemotherapy were analysed.

Results

Fifty-nine BC patients underwent FP: 29 received NAC and 30 received AC. The average interval between diagnosis and chemotherapy in BC patients with NAC was 28.5 days (27.3 (range: 14.0–44.0) days in cases and 29.6 (range: 14.0–62.0) days in controls (NS)); this interval was 58.9 days in BC patients with AC (57.2 (range: 36.0–106.0) days in cases and 60.7 (range: 31.0–105.0) days in controls (NS)).

Conclusion

Fertility preservation does not delay the start of chemotherapy in breast cancer patients.

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Abbreviations

AC:

Adjuvant chemotherapy

ART:

Assisted reproductive technology

ASCO:

American society of clinical oncology

BC:

Breast cancer

Cat.:

Category

CI:

Confidence interval

COS:

Controlled ovarian stimulation

CRG:

Centrum voor reproductieve Geneeskunde

DCIS:

Ductal carcinoma in situ

ER:

Oestrogen receptor

ESMO:

European society for medical oncology

FP:

Fertility preservation

GnRHa:

Gonadotrophin releasing hormone agonists

HER2:

Human epidermal growth factor receptor 2

HR:

Hormone receptor

IDA:

Invasive ductal adenocarcinoma

IVM:

In vitro maturation

KCE:

Belgian health care knowledge centre

Ki67:

A proliferation marker that acts as a prognostic parameter in breast cancer

LCIS:

Lobular carcinoma in situ

NA:

Not applicable

NAC:

Neo-adjuvant chemotherapy

NS:

Non-significant

OPU:

Oocyte pick-up

OTCP:

Ovarian tissue cryopreservation

OTO-IVM:

IVM of ovarian tissue derived oocytes

PR:

Progesterone receptor

QoL:

Quality of life

RSCOS:

Random-start controlled ovarian stimulation

SPSS:

Statistical package for the social sciences

SD:

Standard deviation

IQR:

Interquartile range

CI:

Confidence interval

Q-Q plot:

Quantile–quantile plot

T:

Tumour

N:

Nodes

M:

Metastasis

c:

Clinical

p:

Pathologic

yp:

Pathologic after neo-adjuvant treatment

vs.:

Versus

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Acknowledgements

We would like to thank oncofertility nurse Saskia Van Ginderdeuren for her assistance in collecting the data.

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Authors and Affiliations

  1. Centre for Reproductive Medicine (CRG), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium

    Cynthia D’Hondt, Ellen Van Moer, Ingrid Segers, Herman Tournaye & Michel De Vos

  2. Breast Cancer Clinic, Oncologisch Centrum, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium

    Marian Vanhoeij & Christel Fontaine

  3. Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Sechenov University, Moscow, Russia

    Michel De Vos

Authors
  1. Cynthia D’Hondt
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  2. Marian Vanhoeij
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  3. Ellen Van Moer
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  4. Ingrid Segers
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  5. Christel Fontaine
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  6. Herman Tournaye
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  7. Michel De Vos
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Corresponding author

Correspondence to Michel De Vos.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Data analysis in this retrospective study was in accordance with the ethical standards of the institutional research committee (B.U.N. 143201834864) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Oocyte IVM has been approved as a routine laboratory procedure in our hospital since 2009. The combination of OTCP and OTO-IVM had been approved by the institutional review board (IRB) of the hospital (BUN n° 143201731279) and informed written consent was obtained from all patients.

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D’Hondt, C., Vanhoeij, M., Van Moer, E. et al. Fertility preservation does not delay the initiation of chemotherapy in breast cancer patients treated with adjuvant or neo-adjuvant chemotherapy. Breast Cancer Res Treat 184, 433–444 (2020). https://doi.org/10.1007/s10549-020-05858-1

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  • DOI: https://doi.org/10.1007/s10549-020-05858-1

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