Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Breast Cancer Res Treat. 2022 Sep;195(2):201-208. doi: 10.1007/s10549-022-06650-z. Epub 2022 Jul 30.
To assess the impact of fertility preservation (FP) requiring ovarian stimulation on breast cancer outcomes and pregnancy after breast cancer.
Women aged ≤ 40 years diagnosed with stage I-III breast cancer between 2007 and 2018 and referred for FP consultation prior to systemic therapy were identified from a British Columbia fertility center database. The primary endpoint was invasive breast cancer-free survival (iBCFS) and secondary endpoints were overall survival (OS) and achievement of pregnancy. Survival and pregnancy endpoints were compared using Cox and logistic regression analyses, respectively, for patients who did and did not undergo FP.
The study included 153 patients, with 71 (46%) in the FP group and 82 (54%) in the non-FP group. Patients who underwent FP were more likely to be ECOG 0 (99% vs. 88%, p = 0.011) and receive chemotherapy (93% vs. 67%, p < 0.001), but had similar ER positivity status to non-FP patients (70% vs. 79%, p = 0.21). Over a median follow-up of 4.1 years, there were no differences in iBCFS (HR 1.006, 95% CI 0.416-2.438, p = 0.988) or OS (HR 0.789, 95% CI 0.210-2.956, p = 0.725) between FP and non-FP groups. Patients who underwent FP had higher odds of conceiving at least once (OR 3.024, 95% CI 1.312-6.970, p = 0.008).
At a median follow-up of 4.1 years, FP did not impact iBCFS or OS, supporting its safety in young women with breast cancer. In addition, patients who underwent FP were more likely to become pregnant after breast cancer, highlighting the value of pre-oncologic treatment FP in survivorship family planning.
评估生育力保存（FP）对乳腺癌结局和乳腺癌后妊娠的影响。
从不列颠哥伦比亚生育中心数据库中确定了 2007 年至 2018 年间诊断为 I-III 期乳腺癌且年龄≤40 岁的女性，并在全身治疗前接受 FP 咨询。主要终点为无浸润性乳腺癌生存（iBCFS），次要终点为总生存（OS）和妊娠实现。对于接受 FP 和未接受 FP 的患者，分别使用 Cox 和逻辑回归分析比较生存和妊娠终点。
研究纳入 153 例患者，其中 FP 组 71 例（46%），非 FP 组 82 例（54%）。接受 FP 的患者更有可能为 ECOG 0（99% vs. 88%，p=0.011）和接受化疗（93% vs. 67%，p<0.001），但 ER 阳性状态与非 FP 患者相似（70% vs. 79%，p=0.21）。中位随访 4.1 年后，FP 组和非 FP 组在 iBCFS（HR 1.006，95%CI 0.416-2.438，p=0.988）或 OS（HR 0.789，95%CI 0.210-2.956，p=0.725）方面无差异。接受 FP 的患者怀孕的几率更高（OR 3.024，95%CI 1.312-6.970，p=0.008）。
在中位随访 4.1 年后，FP 对 iBCFS 或 OS 没有影响，支持其在年轻乳腺癌患者中的安全性。此外，接受 FP 的患者在乳腺癌后怀孕的可能性更高，这突出了 FP 在肿瘤前治疗生存规划中的重要价值。
