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前瞻性研究优化年轻乳腺癌患者的卵巢功能和/或生育力保存的护理并提高相关知识:PREgnancy and FERtility(PREFER)研究先导阶段的结果。

Prospective study to optimize care and improve knowledge on ovarian function and/or fertility preservation in young breast cancer patients: Results of the pilot phase of the PREgnancy and FERtility (PREFER) study.

机构信息

Department of Medical Oncology and Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.

Department of Epidemiology, Biostatistics and Clinical Trials, Policlinico San Martino-IST, Genova, Italy.

出版信息

Breast. 2018 Oct;41:51-56. doi: 10.1016/j.breast.2018.06.012. Epub 2018 Jun 22.

Abstract

BACKGROUND

Despite the availability of different strategies for ovarian function and/or fertility preservation in young breast cancer patients candidates for chemotherapy, limited data are available on patients' actual need of these options.

PATIENTS AND METHODS

The PREFER study is a prospective cohort study including premenopausal women with newly diagnosed early stage breast cancer between the age of 18 and 45 years and candidates for chemotherapy. The study aimed to investigate patients' preferences and their choices of the different available strategies for ovarian function and/or fertility preservation (i.e. acceptance rate) and reasons for refusal.

RESULTS

A total of 131 consecutive patients referred from a single breast unit were included. Median age was 38.9 years with 92 patients (70.3%) diagnosed at ≤ 40 years. The majority of patients (122, 93.1%) were concerned about the risk of treatment-induced premature ovarian insufficiency (POI) and/or infertility. A total of 120 (91.6%) patients underwent temporary ovarian suppression with gonadotropin-releasing hormone agonists during chemotherapy for ovarian function preservation. Among patients with ≤40 years, only 11 (12.0%) decided to access cryopreservation strategies for fertility preservation. The main reason for not accessing the fertility unit was completion of family planning before breast cancer diagnosis; for patients who accessed the fertility unit, fear of the procedure was the main reason to refuse the proposed cryopreservation strategies.

CONCLUSION

Despite the majority of young breast cancer patients are concerned about the risk of treatment-induced POI and/or infertility, only a limited number of them required to access the fertility unit to undergo cryopreservation strategies.

摘要

背景

尽管有多种策略可用于保留年轻乳腺癌患者的卵巢功能和/或生育能力,但关于患者对这些选择的实际需求的数据有限。

患者和方法

PREFER 研究是一项前瞻性队列研究,纳入了年龄在 18 至 45 岁之间且适合化疗的新诊断早期乳腺癌的绝经前女性患者。该研究旨在调查患者的偏好及其对不同现有卵巢功能和/或生育力保留策略的选择(即接受率)以及拒绝的原因。

结果

共纳入 131 例连续来自单个乳腺科的患者。中位年龄为 38.9 岁,其中 92 例(70.3%)患者年龄≤40 岁。大多数患者(122 例,93.1%)担心治疗引起的卵巢早衰(POI)和/或不孕的风险。为了保留卵巢功能,120 例(91.6%)患者在化疗期间接受促性腺激素释放激素激动剂进行临时卵巢抑制。在≤40 岁的患者中,仅有 11 例(12.0%)决定采用冷冻保存策略来保留生育力。未进入生育科的主要原因是在乳腺癌诊断前已完成计划生育;对于进入生育科的患者,担心手术是拒绝所建议的冷冻保存策略的主要原因。

结论

尽管大多数年轻乳腺癌患者担心治疗引起的 POI 和/或不孕的风险,但只有少数患者需要进入生育科进行冷冻保存策略。

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