Constance Elizabeth S, Moravek Molly B, Jeruss Jacqueline S
Department of Obstetrics and Gynecology, University of Michigan Health Systems, Ann Arbor, MI, USA.
Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Cancer Treat Res. 2018;173:1-13. doi: 10.1007/978-3-319-70197-4_1.
Breast cancer is the most frequently occurring cancer in women of reproductive age. Treatments for breast cancer may eliminate or diminish fertility, making discussions about fertility preservation essential prior to initiation of gonadotoxic therapies. Additionally, even in patients who do not require chemotherapy, the use of adjuvant endocrine therapy will often push patients out of the reproductive window before treatment is completed. The only established methods for fertility preservation are oocyte or embryo cryopreservation, but experimental methods, such as ovarian suppression with GnRH agonists and ovarian tissue cryopreservation, show great promise. Early referral to a fertility specialist for interested patients affords patients the most fertility preservation options, with only minimal delay to cancer treatment.
乳腺癌是育龄女性中最常见的癌症。乳腺癌治疗可能会消除或降低生育能力,因此在开始性腺毒性治疗之前进行生育力保存的讨论至关重要。此外,即使在不需要化疗的患者中,辅助内分泌治疗的使用也常常会使患者在治疗完成前就超出了生育期。目前唯一确定的生育力保存方法是卵母细胞或胚胎冷冻保存,但实验方法,如使用GnRH激动剂抑制卵巢和卵巢组织冷冻保存,显示出了巨大的前景。对于有兴趣的患者,尽早转诊至生育专家处可为患者提供最多的生育力保存选择,同时对癌症治疗的延迟最小。