Department of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan.
Department of Breast Medical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan.
Breast Cancer. 2024 Nov;31(6):1137-1143. doi: 10.1007/s12282-024-01633-y. Epub 2024 Sep 25.
Data on the desire for pregnancy and the status of fertility preservation (FP) in patients with breast cancer remain unclear. This study aimed to determine the status of patients with breast cancer who desired pregnancy and FP implementation before systemic therapy.
This retrospective study surveyed the institutional clinical databases and electronic medical records of patients aged < 43 years with stages 0-III primary breast cancer during surgery and treated between April 2020 and March 2021. All patients were enquired about their desire for pregnancy in a questionnaire by "present," "absent," and "unsure" at their first visit. The correlation between the desire for pregnancy, implementation of FP, and clinicopathological factors was investigated.
Among 1005 patients who underwent surgery for primary breast cancer, 146 were included in the analysis. Of them, 34 (23.3%) patients had a desire for pregnancy, and 45 (30.8%) chose "unsure." Factors associated with the desire for pregnancy were younger age during surgery (p < 0.0022), unmarried status (p < 0.001), nulliparity (p < 0.001), early-stage disease (p = 0.0016), and estrogen receptor positivity (p = 0.008). Among 115 patients who underwent systemic therapy, 13 (11.3%) underwent FP before systemic therapy. Patients who were nulliparous frequently pursued FP (p = 0.0195). The proportion of FP implementation was low in patients who received neoadjuvant chemotherapy (p = 0.0863).
Our study suggests that unmarried, nulliparous, and younger patients were more interested in pregnancy, and nulliparous patients frequently pursued FP.
关于乳腺癌患者的妊娠意愿和生育力保存（FP）状况的数据仍不清楚。本研究旨在确定在接受系统治疗前有生育意愿和实施 FP 的乳腺癌患者的状况。
这是一项回顾性研究，调查了在 2020 年 4 月至 2021 年 3 月期间手术期间患有 0-III 期原发性乳腺癌且年龄<43 岁的患者的机构临床数据库和电子病历。所有患者在首次就诊时通过“现在”、“不在”和“不确定”三种选项回答了关于妊娠意愿的问卷。调查了妊娠意愿、实施 FP 与临床病理因素之间的相关性。
在接受原发性乳腺癌手术的 1005 名患者中，有 146 名患者被纳入分析。其中，34 名（23.3%）患者有生育意愿，45 名（30.8%）选择“不确定”。与生育意愿相关的因素包括手术时年龄较小（p<0.0022）、未婚状态（p<0.001）、未婚（p<0.001）、早期疾病（p=0.0016）和雌激素受体阳性（p=0.008）。在接受系统治疗的 115 名患者中，有 13 名（11.3%）在接受系统治疗前接受了 FP。未育患者经常选择 FP（p=0.0195）。在接受新辅助化疗的患者中，实施 FP 的比例较低（p=0.0863）。
本研究表明，未婚、未育和年轻的患者对妊娠更感兴趣，未育患者经常选择 FP。
