The risk of disease recurrence or disease-specific mortality is not raised in women with a diagnosis of breast cancer who undergo operations for fertility preservation. This was demonstrated in a study conducted by the Karolinska Institutet in Sweden, where individuals were tracked for an average of five years. The findings, which were published in the journal JAMA Oncology, may one day offer security and renewed hope to women who wish to maintain their fertility following chemotherapy for cancer.
Women of childbearing age who have breast cancer are almost one in ten times more likely to experience infertility as a result of chemotherapy. Many cancer patients decide to undertake hormonally stimulated or non-hormonally stimulated fertility preservation operations in the hopes of being able to start a family after completing their cancer treatment. These techniques include cryopreservation, which involves freezing ovarian tissue, female gametes (oocytes), and embryos.
It is not uncommon for women with hormone-positive breast cancer or their medical professionals to decide against fertility preservation procedures out of concern that doing so will raise the likelihood of cancer recurrence or death. In some circumstances, women are also counseled to wait for 5 to 10 years before attempting conception, since fertility declines with age in all women. According to the study's first author Anna Marklund, a researcher at the Department of Oncology-Pathology, more information is required on the security of procedures for fertility preservation at the time of a breast cancer diagnosis.
Researchers at the Karolinska Institutet and Karolinska University Hospital examined whether treatments for fertility preservation following a breast cancer diagnosis are associated with an elevated chance of the disease returning or dying. The ladies were observed by the study for an average of five years.
The registry study included 1,275 Swedish women of reproductive age who received breast cancer treatment between 1994 and 2017. 425 of them underwent treatments to preserve their fertility, either with or without hormonal stimulation. 850 women in the control group had treatment for breast cancer but did not get fertility preservation measures.
On the basis of age, calendar year, and healthcare region at the time of diagnosis, the women who underwent fertility preservation operations and the women in the control group were matched. The statistical information, which included information on outcomes, disease- and treatment-related factors, and socioeconomic indicators, was gathered from both national healthcare registers and population registers.
Over the course of five years, 89% of women who underwent hormonal stimulation of the ovaries, 83% of women who underwent ovarian tissue freezing, and 82% of women who did not undergo procedures for fertility preservation saw no relapse.
The survival percentage for breast cancer patients five years following treatment was 96% in the group that had hormonal stimulation to freeze eggs or embryos, compared to 93 % for the group that underwent fertility preservation operations without hormone stimulation and 90% for the group that did not.
"We found no difference between the women who underwent fertility preservation operations and those who did not in terms of an increased risk of relapse or mortality. According to the study's final author Kenny Rodriguez-Wallberg, chief physician at Karolinska University Hospital and adjunct professor and research group leader at the Department of Oncology-Pathology, Karolinska Institutet, this is important information that could help change care practices for young women with breast cancer who want to preserve their fertility.
After another five years, the researchers will revisit the findings.
The Swedish Cancer Society, the Breast Cancer Association, Region Stockholm, and Karolinska Institutet all provided funding for the study. No reported conflicts of interest exist.
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