A five year Swedish study of 1,275 women with an average age of 32.9 years has found that “fertility preservation is not linked to mortality or relapse in breast cancer, and the rates are comparable to unexposed patients”.
The nationwide prospective cohort study found no increased risk between undergoing procedures to preserve fertility (such as egg freezing and cryopreservation of ovarian tissue), with or without hormonal stimulation and a woman dying from breast cancer or developing it again at a later date.
Of the women in the study, 425 women underwent fertility preservation procedures.
The study, led by Kenny Rodriguez-Wallberg, MD, PhD, of the Karolinska University Hospital Huddinge in Stockholmfound similar trends in mortality and relapse in women with breast cancer if they had no fertility preservation procedures compared with both those who had procedures to preserve fertility with the use of hormonal stimulation and those who had procedures to preserve fertility without the use of hormonal stimulation.
In addition to this, the study found that within a sub cohort of 723 women “there was no statistically significant difference in the rate of relapse or death among women who underwent hormonal fertility preservation and those who underwent nonhormonal fertility preservation.
To put this into perspective, after five years of having treatment for breast cancer, the survival rates, that is, the percentage of women still alive after five years, were as follows:
After five years, the relapse-free survival rates, that is the percentage of women who didn’t go on to develop breast cancer again were:
After ten years the relapse-free survival rates were:
Dr Rodriguez-Wallberg and his team concluded, “Results of this study provide much needed additional evidence on the safety of fertility preservation procedures in women with breast cancer and may influence current health care practice to the benefit of young women who wish to preserve their fertility”.
“Women diagnosed with breast cancer during their reproductive years should be referred, when interested, for fertility counselling and provided with the available information on safety of the procedures that are offered.”
Sadly, 17 women in the study who underwent hormonal fertility preservation died due to breast cancer. Seven women also died due to breast cancer who had non hormonal fertility preservation and 80 women died due to breast cancer who had no fertility preservation procedures.
Dr Rodriguez-Wallberg and his team say “the study’s strengths included its large size, as well as the use of prospectively collected data”. However, they also acknowledged that the study “is not without limitations, the main one being relatively short follow-up, though to our knowledge, one of the longest reported so far.”
“Longer follow-up is desirable for more definitive statements on long-term safety of fertility preservation in this population, in particular for women with oestrogen receptor-positive breast cancer.”
“Nevertheless, the specific analyses restricted to women with follow-up longer than 5 years in this study also provide reassuring findings.”
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