scholarly journals Factors Associated With the Discussion of Fertility Preservation in a Cohort of 1,357 Young Breast Cancer Patients Receiving Chemotherapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Alice Hours ◽  
Aullene Toussaint ◽  
Victoire De Castelbajac ◽  
Camille Sautter ◽  
Julie Borghese ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Patient Characteristics ◽  
Female Breast Cancer ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Number Of Children ◽  
Physician Characteristics ◽  
Younger Age ◽  
Young Breast Cancer

PurposeFemale breast cancer (BC) patients exposed to gonadotoxic chemotherapy are at risk of future infertility. There is evidence of disparities in the discussion of fertility preservation for these patients. The aim of the study was to identify factors influencing the discussion of fertility preservation (FP).Material and MethodsWe analyzed consecutive BC patients treated by chemotherapy at Institut Curie from 2011-2017 and aged 18-43 years at BC diagnosis. The discussion of FP was classified in a binary manner (discussion/no discussion), based on mentions present in the patient’s electronic health record (EHR) before the initiation of chemotherapy. The associations between FP discussion and the characteristics of patients/tumors and healthcare practitioners were investigated by logistic regression analysis.ResultsThe median age of the 1357 patients included in the cohort was 38.7 years, and median tumor size was 30.3 mm. The distribution of BC subtypes was as follows: 702 luminal BCs (58%), 241 triple-negative breast cancers (TNBCs) (20%), 193 HER2+/HR+ (16%) and 81 HER2+/HR- (6%). All patients received chemotherapy in a neoadjuvant (n=611, 45%) or adjuvant (n= 744, 55%) setting. A discussion of FP was mentioned for 447 patients (33%). Earlier age at diagnosis (discussion: 34.4 years versus no discussion: 40.5 years), nulliparity (discussion: 62% versus no discussion: 38%), and year of BC diagnosis were the patient characteristics significantly associated with the mention of FP discussion. Surgeons and female physicians were the most likely to mention FP during the consultation before the initiation of chemotherapy (discussion: 22% and 21%, respectively). The likelihood of FP discussion increased significantly over time, from 15% in 2011 to 45% in 2017. After multivariate analysis, FP discussion was significantly associated with younger age, number of children before BC diagnosis, physicians’ gender and physicians’ specialty.ConclusionFP discussion rates are low and are influenced by patient and physician characteristics. There is therefore room for improvement in the promotion and systematization of FP discussion.

Fertility preservation in young breast cancer patients: A population-based study.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 90-90
Author(s):  
Diana Nguyen ◽  
Ghader Jamjoum ◽  
Ari N. Meguerditchian
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Service Use ◽  
Estrogen Therapy ◽  
Population Based ◽  
Administrative Claims ◽  
Breast Cancer Patients ◽  
Population Based Study ◽  
Young Breast Cancer ◽  
Universal Health

90 Background: Treatment-related infertility is an important cause of distress in young women with breast cancer (YWBC) that is preventable by fertility preservation (FP) prior to initiating therapy. This study assesses FP service use by YWBC in Quebec (Canada). Methods: Administrative claims for women ≤ 40 diagnosed between 01-04-2012 and 31-03-2018 were identified using Quebec’s universal health services database (RAMQ). Access to and use of FP services were ascertained by identifying claims for a visit with an obstetrician/gynecologist (OB/GYN) ≤ 90 days of diagnosis, followed by claims for ovarian stimulation, ovule harvesting or artificial insemination. Patient, disease and treatment-related predictors were estimated using logistic regression. Results: 1 616 YWBC were treated. Mean age was 36 (SD 4.1), 72.1% had a CCI = 0, 84.5% were urban residents, and 72.2% experienced some form of socioeconomical disadvantages. Stage distribution was: 0.93%, 68.8, and 30.3% for stages 0, 1-2, and 3 respectively. 53.0% had a mastectomy, 40.8% received chemotherapy (CT), 70.7% received radiotherapy, 20.9% initiated anti-estrogen therapy. 387 YWBC consulted an OB/GYN within 90 days of diagnosis and 155 subsequently received FP services. Predictors associated with FP use included: decreased age (OR= 0.82, 95CI = 0.79-0.86), type of surgery (OR = 0.46, CI = 0.22-0.97), social isolation (OR =1.39, 95CI = 0.99-1.96) and receipt of chemotherapy (OR = 1.74, 95CI = 1.10-2.76). Conclusions: Only 23.9% of eligible YWBC in Quebec accessed FP specialists. Of these, 40.1% chose to move forward with FP. These findings raise important questions on how to optimize access to FP expertise. [Table: see text]

scholarly journals Significant Post-Chemotherapy Decrease of Ovarian Reserve in Iranian Women With Breast Cancer

2020 ◽  
Author(s):  
Bita Eslami ◽  
Amirmohsen Jalaeefar ◽  
Ashraf Moini ◽  
Ramesh Omranipour ◽  
Maryam Haghighi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Ovarian Function ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Study Results ◽  
Young Breast Cancer ◽  
Almost All ◽  
First Time

Fertility preservation counseling has a high priority in young breast cancer (BC) patients. Cytotoxic chemicals used for chemotherapy in these patients increased the risk of premature ovarian failure. This study evaluated the anti-mullerian hormone (AMH) level at the time of diagnosis and within a month after the end of chemotherapy, while predicting the time of the return of ovarian function in BC cases (n=46) younger than 46 years for the first time in Iran. Cases were selected from those attending the breast oncology clinic of the two hospitals with a newly diagnosed in situ or invasive BC. The present study results showed AMH levels were significantly decreased in almost all women within a month after chemotherapy. It seems that the need for fertility preservation depends on patient age and baseline AMH level, but counseling should be offered by the clinician in young breast cancer patients.

scholarly journals A retrospective study evaluating the impact of scattering radiation from imaging procedures on oocyte quality during ovarian stimulation for fertility preservation in young breast cancer patients

2021 ◽  
Author(s):  
Margherita Condorelli ◽  
Maëlle Sens ◽  
Ornit Goldrat ◽  
Anne Delbaere ◽  
Judith Racapé ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Ionizing Radiation ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Ovarian Stimulation ◽  
Oocyte Quality ◽  
Embryo Cryopreservation ◽  
Breast Cancer Patients ◽  
Young Breast Cancer

Abstract Purpose Ovarian stimulation for oocyte and embryo cryopreservation is the standard of care for fertility preservation in young breast cancer patients before gonadotoxic chemotherapy. The procedure should be started as soon as possible to avoid delay of treatment; thus, it is often performed concomitantly with tumor staging assessments. However, questions remain regarding the potential negative impact on oocyte quality that may occur due to exposure to scattered ionizing radiation from imaging techniques when staging assessment is conducted at the same time as ovarian stimulation. Methods We conducted a retrospective study on all breast cancer patients who received ovarian stimulation for fertility preservation at our center between November, 2012 and May, 2020. Results Gynecologic and oncologic characteristics were similar between patients exposed (n = 14) or not (n = 60) to ionizing radiation. Exposed patients started the ovarian stimulation sooner after diagnosis than non-exposed patients (11.5 vs 28 days, respectively, P < 0.01). Cycle parameters, including the median number of oocytes collected (10.5 vs 7, P = 0.16), maturation rates (92.5% vs 85.7%, P = 0.54), and fertilization rates (62.2% vs 65.4%, P = 0.70) were similar between groups. Conclusions This study shows that scattered ionizing radiation due to staging assessment appears to be safe without compromising follicular growth and maturation. Larger studies on fertility and obstetrical outcomes are needed to confirm these preliminary data.

Our act on fertility preservation for young breast cancer patients in our single institute.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 109-109 ◽  
Author(s):  
Yasuyuki Kojima ◽  
Kyoko Tsuchiya ◽  
Chie Nishijima ◽  
Nao Suzuki ◽  
Koichiro Tsugawa
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Reproductive Age ◽  
Ovarian Tissue Cryopreservation ◽  
Embryo Cryopreservation ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Er Positive ◽  
Young Breast Cancer

109 Background: Along with increasing number of newly diagnosed Japanese breast cancer patients, the number of breast cancer survivors in reproductive age is also increasing. Among newly diagnosed Japanese breast cancer patients, 3182(6.6%) are under age 40 in 2011, which was 1610 in 2006. In our institute, we have been cooperating with gynecologists and providing fertility preservation program since 2010. Our aim is to access our team management, clinical impact and outcome of fertility preservation among young breast cancer patients in our institute. Methods: A patient, 1)without distant metastasis, 2)systemic chemotherapy and/or hormonal therapy planned, 3)within reproductive age and 4)willing to preserve fertility, will be referred to oncofertility clinic. Chart review was done retrospectively. Results: Ninety-five patients had consultation to the oncofertility clinic between April 2010 and April 2015. The average age at consultation was 34.1(range 22-44). Almost all patient had invasive cancer; cStage0:4%, cStageI:31%, cStageII:53%, cStageIII:11%. Fifty-five percent had estrogen receptor (ER) positive/HER2 negative, 31% had ER positive/HER2positive, 2% had ER negative/HER2 positive and 12% had ER negative/HER2 negative breast cancer. Forty-five had counseling without any procedure, 22 underwent ovarian tissue cryopreservation, 17 underwent embryo cryopreservation and 8 underwent oocyte cryopreservation. Because observation period is still short, we haven’t had any case that got pregnant or delivered, yet. Conclusions: The number of patient who choose to underwent fertility preservation is increasing. We have actually started facing proposition, when we shall lay aside adjuvant therapy and let them plan to be conceived. Taking risk into account, we are now evaluating the safety of cancer treatment and outcome of each procedure which undergone multidisciplinary deliberate decision-making process.

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