Ying Wang1, Megan E Tesch1, Chloe Lim2, Ying Hui Xu3, Shaina Lee4, Kirstin Perdizet5, Dan Yokom6, Ellen Warner7, Jeffery Roberts8, Caroline A Lohrisch9. 1. Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada. 2. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 3. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 4. Division of Oncology and Department of Gynecology, Allan Blair Cancer Centre, Regina, SK, Canada. 5. William Osler Health System, Brampton, ON, Canada. 6. Trillium Health Partners, Credit Valley Hospital, Mississauga, ON, Canada. 7. Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada. 8. Pacific Centre for Reproductive Medicine, Vancouver, BC, Canada. 9. Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada. clohrisch@bccancer.bc.ca.
Abstract
PURPOSE: To assess the impact of fertility preservation (FP) requiring ovarian stimulation on breast cancer outcomes and pregnancy after breast cancer. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
PURPOSE: To assess the impact of fertility preservation (FP) requiring ovarian stimulation on breast cancer outcomes and pregnancy after breast cancer. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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Authors: Matteo Lambertini; Halle C F Moore; Robert C F Leonard; Sibylle Loibl; Pamela Munster; Marco Bruzzone; Luca Boni; Joseph M Unger; Richard A Anderson; Keyur Mehta; Susan Minton; Francesca Poggio; Kathy S Albain; Douglas J A Adamson; Bernd Gerber; Amy Cripps; Gianfilippo Bertelli; Sabine Seiler; Marcello Ceppi; Ann H Partridge; Lucia Del Mastro Journal: J Clin Oncol Date: 2018-05-02 Impact factor: 44.544
Authors: Philip D Poorvu; Jiani Hu; Yue Zheng; Shari I Gelber; Kathryn J Ruddy; Rulla M Tamimi; Jeffrey M Peppercorn; Lidia Schapira; Virginia F Borges; Steven E Come; Ellen Warner; Matteo Lambertini; Shoshana M Rosenberg; Ann H Partridge Journal: NPJ Breast Cancer Date: 2021-07-27