Department of Obstetrics and Gynecology, McGill University, 1001 Decarie Blvd., Montreal, QC, H4A 3J1, Canada.
Department of Obstetrics and Gynecology, Hadassah Medical Center, Kiryat Hadassah, Jerusalem, 91120, Israel.
J Assist Reprod Genet. 2020 Apr;37(4):913-921. doi: 10.1007/s10815-020-01730-9. Epub 2020 Mar 6.
To evaluate fertility preservation outcomes in breast cancer women with different hormonal receptor profiles before oncological treatment.
The study population included women with a diagnosis of breast cancer who underwent fertility preservation from 2009 until 2018 at a university-affiliated tertiary hospital. Stimulation parameters and fertility preservation outcomes were compared among the following receptor-specific profile groups: (1) estrogen receptor positive (ER+) versus estrogen receptor negative (ER-), (2) triple-negative breast cancer (TNBC) versus estrogen and progesterone receptor positive (ER+/PR+), and (3) TNBC versus non-TNBC. Primary outcome was the total number of mature oocytes. Secondary outcomes included the number of retrieved oocytes, the peak estradiol level, and the number of follicles > 14 mm on the final oocyte maturation trigger day.
A total of 155 cycles were included in the final analysis. These were divided into the exposure groups of ER+ (n = 97), ER- (n = 58), ER+/PR+ (n = 85), TNBC (n = 57), and non-TNBC (n = 98). Cycle outcomes revealed similar number of retrieved oocytes and follicles > 14 mm on the trigger day. Women with TNBC had significantly lower number of mature oocytes compared with those with ER + PR+ (7 (5-11) versus 9 (7-15); p = 0.02) and non-TNBC (7 (5-11) versus 9 (7-16); p = 0.01) status. Triple-negative breast cancer profile was associated with a significant reduction in the chance of developing over 10 mature oocytes (OR 0.41; 95% CI 0.19-0.92).
Among the different hormonal receptor profiles in breast cancer, the TNBC subtype has a negative effect on fertility preservation outcomes.
评估不同激素受体谱的乳腺癌女性在肿瘤治疗前进行生育力保存的结果。
本研究人群包括 2009 年至 2018 年在一家大学附属医院接受生育力保存的乳腺癌诊断女性。在以下受体特异性谱组之间比较刺激参数和生育力保存结果：（1）雌激素受体阳性（ER+）与雌激素受体阴性（ER-），（2）三阴性乳腺癌（TNBC）与雌激素和孕激素受体阳性（ER+/PR+），和（3）TNBC 与非 TNBC。主要结局是成熟卵母细胞总数。次要结局包括卵母细胞数、取卵数、峰值雌二醇水平和最后卵母细胞成熟触发日的>14mm 卵泡数。
共纳入 155 个周期进行最终分析。这些周期分为暴露组 ER+（n=97）、ER-（n=58）、ER+/PR+（n=85）、TNBC（n=57）和非 TNBC（n=98）。周期结果显示取卵数和触发日>14mm 的卵泡数相似。与 ER+/PR+（7（5-11）与 9（7-15）；p=0.02）和非 TNBC（7（5-11）与 9（7-16）；p=0.01）相比，TNBC 组的成熟卵母细胞数明显减少。三阴性乳腺癌谱与成熟卵母细胞数超过 10 个的可能性显著降低相关（OR 0.41；95%CI 0.19-0.92）。
在乳腺癌的不同激素受体谱中，TNBC 亚型对生育力保存结果有负面影响。
