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体外受精对患乳腺癌风险的影响。

In vitro fertilization impact on the risk of breast cancer.

作者信息

Mihai Ana-Maria, Ianculescu Laura Maria, Creţoiu Dragoş, Suciu Nicolae

机构信息

Alessandrescu-Rusescu National Institute for Mother and Child Health, Bucharest, Romania.

Ponderas Academic Hospital, Regina Maria Private Healthcare Network, Bucharest, Romania.

出版信息

Arch Clin Cases. 2024 Oct 9;11(3):73-82. doi: 10.22551/2024.44.1103.10292. eCollection 2024.

Abstract

Breast cancer, with its increasing incidence and high mortality rates, remains a major global health challenge, significantly impacting individuals, families, and societies. Understanding the multifactorial risk factors contributing to its development is crucial for effective prevention and management. Hormonal factors play a significant role in breast cancer development. Given that ovarian steroid hormones influence breast function, any gonadotropin hormone or fertility drug that stimulates ovulation may also impact breast tissue. Contrary to the findings of studies with smaller sample sizes, concerns have emerged regarding the potential increased risk of breast cancer following in vitro fertilization (IVF) treatments. This article explores the potential risk of breast cancer associated with hormonal cycles during IVF, supported by a literature review and a case study conducted in a tertiary hospital in Bucharest, Romania. The case involves a 38-year-old patient with a history of hormonally treated endometriosis and five IVF cycles, who presented for mammographic and ultrasound screening. The screening revealed multicentric and multifocal BIRADS-5 lesions, with histopathological and immunohistochemical analysis confirming invasive breast carcinoma of no special type with ductal carcinoma in situ, HER2 positive (3+), estrogen receptor and progesterone receptor negative, and a Ki-67 proliferation index of 50%.

摘要

乳腺癌发病率不断上升且死亡率居高不下,仍然是一项重大的全球健康挑战,对个人、家庭和社会都产生了重大影响。了解导致其发生的多因素风险因素对于有效的预防和管理至关重要。激素因素在乳腺癌的发生中起着重要作用。鉴于卵巢甾体激素会影响乳腺功能,任何刺激排卵的促性腺激素或生育药物也可能影响乳腺组织。与样本量较小的研究结果相反,体外受精(IVF)治疗后乳腺癌潜在风险增加的担忧已经出现。本文通过文献综述以及在罗马尼亚布加勒斯特一家三级医院进行的案例研究,探讨了体外受精期间与激素周期相关的乳腺癌潜在风险。该案例涉及一名38岁患者,有激素治疗子宫内膜异位症病史且经历过五次体外受精周期,前来进行乳房X光和超声筛查。筛查发现多中心和多灶性BIRADS-5病变,组织病理学和免疫组织化学分析证实为非特殊类型浸润性乳腺癌伴原位导管癌,HER2阳性(3+),雌激素受体和孕激素受体阴性,Ki-67增殖指数为50%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27d7/11520175/e6356f93df94/acc-11-03-10292-g001.jpg

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