Tomasi-Cont Nicoletta, Lambertini Matteo, Hulsbosch Sofie, Peccatori Alessandro Fedro, Amant Frederic
Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital "Umberto I", University of Turin, Turin, Italy; Fertility and Pregnancy Unit, Medical Gynecologic Oncology Division, European Institute of Oncology, Milan, Italy.
U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
Breast. 2014 Oct;23(5):503-10. doi: 10.1016/j.breast.2014.05.024. Epub 2014 Jun 13.
Diagnosis of breast cancer in young women poses a threat to fertility. Due to a recent trend of delaying pregnancy, an increasing number of breast cancer patients in reproductive age wish to bear children. Health care providers have the responsibility to know how to manage fertility issues in cancer survivors. Oncofertility counseling is of great importance to many young women diagnosed with cancer and should be managed in a multi-disciplinary background. Most of young breast cancer patients are candidate to receive chemotherapy, which could lead to premature ovarian failure. A baseline evaluation of ovarian reserve may help in considering the different fertility preservation options. The choice of the suitable strategy depends also on age, type of chemotherapy, partner status and patients' motivation. Various options are available, some established such as embryo and oocyte cryopreservation, some still experimental such as ovarian tissue cryopreservation and ovarian suppression with GnRHa during chemotherapy. An early referral to a reproductive specialist should be offered to patients at risk of infertility who are interested in fertility preservation.
年轻女性乳腺癌的诊断对生育能力构成威胁。由于近期存在推迟怀孕的趋势，越来越多处于生育年龄的乳腺癌患者希望生育子女。医疗保健提供者有责任了解如何处理癌症幸存者的生育问题。肿瘤生育咨询对许多被诊断患有癌症的年轻女性非常重要，应在多学科背景下进行处理。大多数年轻乳腺癌患者适合接受化疗，而化疗可能导致卵巢早衰。卵巢储备功能的基线评估有助于考虑不同的生育力保存方案。合适策略的选择还取决于年龄、化疗类型、伴侣状况和患者的意愿。有多种选择可供使用，一些是已确立的方法，如胚胎和卵母细胞冷冻保存，一些仍处于实验阶段，如卵巢组织冷冻保存以及化疗期间使用促性腺激素释放激素类似物（GnRHa）进行卵巢抑制。对于有不孕风险且对生育力保存感兴趣的患者，应尽早转诊至生殖专家处。
