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| |  Fertility Procedures Need Not Delay Breast Cancer Treatment for Younger Women CHICAGO -- November 13, 2009 -- A study published in the November issue of the Journal of the American College of Surgeons shows that breast cancer patients aged under 40 years who undergo fertility preservation do not face a significant delay in the treatment of their disease when their care is coordinated in a timely fashion. “Easy access and good communication among surgeons, medical oncologists and reproductive endocrinologists is critical,” said Lynn Westphal, MD, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California. Frequently, young women who are diagnosed with breast cancer must make difficult decisions about surgical treatment options as well as chemotherapeutic treatments that may permanently impair their fertility or delay childbearing. Advancements in reproductive medicine such as in vitro fertilisation have benefited young women with breast cancer. “The burden of facing premature menopause adds to the stress experienced by young cancer survivors,” said Irene Wapnir, MD, Department of Surgery, Stanford University School of Medicine. “Fertility preservation through cryopreservation of eggs or fertilised oocytes may be an important measure to offset these concerns and promote emotional well-being. Our study shows that these procedures, when expedited and appropriately timed, do not delay cancer treatment.” Researchers used the Stanford Cancer Center tumour registry to retrospectively identify 82 women aged younger than 40 years who received adjuvant chemotherapy for breast cancer. Of the women identified, 19 underwent ovarian stimulation and oocyte retrieval, and 63 did not. The timing of fertility preservation, surgical intervention, and chemotherapy were compared with the time intervals between diagnosis and treatment in the patients who did not undergo fertility preservation. The research team found that the median time from initial diagnosis to chemotherapy in women who underwent fertility preservation was 71 days (range, 45-161 days) versus 67 days among those who did not (range, 27-144 days; P < .22). The median time interval from definitive operation to chemotherapy was similar in the 2 groups (P < .79): 30 days for women undergoing fertility preservation (range, 14-100 days) and 29 days for women in the control group (range, 12-120 days). For women undergoing fertility preservation, the median time from initial diagnosis to a reproductive consultation was 30 days (range, 4-133 days) and from referral to fertility preservation was 32 days (range, 13-66 days). The mean age of the women who underwent fertility preservation was 33.7 years, and 84.2% had not previously given birth. Among women who did not undergo fertility treatment, the mean age was 35.2 years, and 25.4% had not previously given birth. The 2 groups were dissimilar with respect to stage of disease: 47.3% of patients in the fertility preservation group had node-negative disease, compared with 25.4% in the control group. Furthermore, 73.7% of the fertility preservation group had oestrogen-positive tumours, compared with 65.1% of the control group. SOURCE: Weber Shandwick Worldwide
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