Liu Shang-Min, Huang Shang-Yu, Wu Hsien-Ming, Chang Chia-Lin, Huang Hong-Yuan
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Shin Street, Kwei-Shan, Tao-Yuan, Taiwan.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, 5 Fu-Shin Street, Kwei-Shan, Tao-Yuan, Taiwan; Chang Gung University College of Medicine, 259 Wen-Hua 1st Road, Kwei-shan, Tao-Yuan, Taiwan.
J Formos Med Assoc. 2025 Mar;124(3):241-245. doi: 10.1016/j.jfma.2024.08.031. Epub 2024 Aug 29.
This study aimed to explore the potential impact of stage, grade, and hormone receptor profile on ovarian stimulation response and fertility preservation outcomes.
This retrospective cohort study evaluated data from breast cancer patients who underwent fertility preservation at a tertiary medical center between 2014 and 2022. The outcomes of women with low-stage cancer (stages I and II) were compared with those of women with high-stage disease (stages III and IV or lymph node metastasis). Similarly, we compared those with low-grade (grades 1 and 2) and high-grade (grade 3) malignancies. In addition, we compared different hormone statuses of breast cancer (1) estrogen receptor (ER) positive vs. ER-negative and (2) triple-negative breast cancer (TNBC) vs. non-TNBC. The primary outcome measured was the number of mature oocytes, while the secondary outcomes included the numbers of total oocytes retrieved, peak estradiol levels, and subsequent fertility preservation outcomes.
A total of 47 patients were included. Patients with high-grade tumors had a comparable number of mature oocytes (8 vs. 10, p = 0.08) compared to patients with low grade cancers. The stage-based analysis revealed a similar number of mature oocytes (8 vs. 10, p = 0.33) between high/low stage patients. In the hormone receptor-based analysis, no differences were seen in mature oocytes collected between the ER-positive/ER-negative group (9 vs. 9, p = 0.87) and the TNBC/non-TNBC group (11 vs. 9, p = 0.13). The utilization rate was 27.6% (13/47).
Our study showed similar ovarian stimulation response and fertility preservation outcomes among breast cancer patients with different prognostic factors.
本研究旨在探讨分期、分级和激素受体谱对卵巢刺激反应和生育力保存结局的潜在影响。
这项回顾性队列研究评估了2014年至2022年间在一家三级医疗中心接受生育力保存的乳腺癌患者的数据。将低分期癌症（I期和II期）女性的结局与高分期疾病（III期和IV期或淋巴结转移）女性的结局进行比较。同样，我们比较了低级别（1级和2级）和高级别（3级）恶性肿瘤患者。此外，我们比较了乳腺癌的不同激素状态：（1）雌激素受体（ER）阳性与ER阴性；（2）三阴性乳腺癌（TNBC）与非TNBC。测量的主要结局是成熟卵母细胞的数量，次要结局包括回收的总卵母细胞数量、雌二醇峰值水平以及随后的生育力保存结局。
共纳入47例患者。与低级别癌症患者相比，高级别肿瘤患者的成熟卵母细胞数量相当（8个对10个，p = 0.08）。基于分期的分析显示，高/低分期患者之间的成熟卵母细胞数量相似（8个对10个，p = 0.33）。在基于激素受体的分析中，ER阳性/ER阴性组（9个对9个，p = 0.87）和TNBC/非TNBC组（11个对9个，p = 0.13）之间收集的成熟卵母细胞没有差异。利用率为27.6%（13/47）。
我们的研究表明，具有不同预后因素的乳腺癌患者在卵巢刺激反应和生育力保存结局方面相似。
