Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, 499 Illinois Street, 6th Floor, CA, 94158, San Francisco, USA.
School of Medicine, University of California, San Francisco, 533 Parnassus Avenue, San Francisco, CA, 94143, USA.
J Assist Reprod Genet. 2022 May;39(5):1155-1161. doi: 10.1007/s10815-022-02473-5. Epub 2022 Mar 23.
To investigate if breast cancer stage and grade affect fertility preservation outcomes.
We performed a retrospective cohort study that included premenopausal women with breast cancer undergoing fertility preservation diagnosed between January 2011 and January 2019. The primary outcome measure was the number of mature oocytes (MII) per antral follicle count (AFC). Secondary outcome measures included total oocytes retrieved, total mature oocytes retrieved, and greater than 10 mature oocytes preserved. Univariate and multivariate models were used to assess the association of low vs. high stage (low stage I-II and high stage III-IV) and grade I vs. grade II/III with each outcome, with adjustment for confounders.
A total of 267 premenopausal breast cancer patients undergoing fertility preservation were included in our study, with the majority presenting with low stage (N = 215, 80.5%), grade II/III (N = 235, 88.1%) disease. Baseline AFC, total gonadotropin dose, days of stimulation, and follicles [Formula: see text] 13 mm on the day of trigger did not differ by stage or grade. After adjusting for age, BMI, and baseline AFC, we found that the mean MII per AFC did not differ by stage (1.0 vs. 1.1, P = 0.3) or grade (1.0 vs. 1.0, P = 0.92). Similarly, total oocytes retrieved, total MII retrieved, and percentage of patients who were able to preserve greater than 10 MII did not differ by breast cancer stage or grade (all P > 0.2).
Breast cancer grade and stage do not impact ovarian stimulation or fertility preservation outcome.
探讨乳腺癌分期和分级是否影响生育力保存的结果。
我们进行了一项回顾性队列研究,纳入了 2011 年 1 月至 2019 年 1 月期间诊断为乳腺癌且接受生育力保存的绝经前妇女。主要观察指标为每个窦卵泡计数(AFC)的成熟卵母细胞(MII)数。次要观察指标包括总获卵数、总成熟卵母细胞数和保存的 MII 数大于 10。采用单变量和多变量模型评估低期(低Ⅰ-Ⅱ期和高Ⅲ-Ⅳ期)和低分级(Ⅰ级)与高分级(Ⅱ/Ⅲ级)与各结局的相关性,调整混杂因素。
本研究共纳入 267 例接受生育力保存的绝经前乳腺癌患者,大多数患者为低分期(N=215,80.5%)和低分级(Ⅱ/Ⅲ级)疾病(N=235,88.1%)。分期或分级不同,基础 AFC、总促性腺激素剂量、刺激天数和触发日[Formula: see text]13mm 的卵泡数无差异。调整年龄、BMI 和基础 AFC 后,我们发现 MII 与 AFC 的平均比值在分期(1.0 比 1.1,P=0.3)或分级(1.0 比 1.0,P=0.92)方面无差异。同样,总获卵数、总 MII 获卵数以及能够保存 MII 数大于 10 的患者比例在乳腺癌分期或分级方面无差异(所有 P>0.2)。
乳腺癌分级和分期不影响卵巢刺激或生育力保存的结果。