Friedlander M, Thewes B
Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Intern Med J. 2003 Aug;33(8):372-9. doi: 10.1046/j.1445-5994.2003.00377.x.
As the mortality rate from breast cancer decreases, the issues facing breast cancer survivors are becoming increasingly important. Survivors of all ages may face physical and psychosocial consequences of their diagnosis and treatments. However, the long-term fertility and menopause-related side-effects of adjuvant therapy uniquely affect younger premenopausal breast cancer survivors. This article provides an evidence-based overview of the reproductive and gynaecological impact of breast cancer therapy for premenopausal women diagnosed with breast cancer. The physical and psychosocial implications of premature menopause are presented. Strategies for preserving fertility in selected patients are also discussed. Recent clinical trials strongly indicate that premenopausal women with oestrogen receptor positive tumours should receive endocrine therapy. The increased use of endocrine therapies in younger women raises important questions regarding patient information needs and treatment decision-making.
随着乳腺癌死亡率的下降，乳腺癌幸存者面临的问题变得越来越重要。各年龄段的幸存者都可能面临诊断和治疗带来的身体和心理社会后果。然而，辅助治疗的长期生育能力和与更年期相关的副作用对年轻的绝经前乳腺癌幸存者有独特的影响。本文基于证据概述了乳腺癌治疗对绝经前被诊断为乳腺癌的女性的生殖和妇科影响。文中介绍了过早绝经的身体和心理社会影响。还讨论了为特定患者保留生育能力的策略。近期的临床试验有力地表明，雌激素受体阳性肿瘤的绝经前女性应接受内分泌治疗。年轻女性中内分泌治疗的使用增加引发了关于患者信息需求和治疗决策的重要问题。
