Fertility and the impact of systemic therapy on hormonal status following treatment for breast cancer.
Issues of long-term toxicity from treatment for breast cancer, including the induction of premature ovarian failure, appear to be of increasing importance for breast cancer survivors. The incidence of treatment-related amenorrhea is related to patient age and to the treatment regimen. Whereas the induction of ovarian failure may be advantageous with respect to breast cancer outcome, it is not clear that there is any advantage to permanent menopause over reversible hormonal manipulations. In addition, menopause may be associated with a variety of adverse health effects. Although nonhormonal therapies are available to manage many of the consequences of menopause, avoidance of chemotherapy-related ovarian toxicity may provide the best prospects for fertility after treatment. Pregnancy after breast cancer is a realistic consideration for some breast cancer survivors and is not clearly detrimental to either the mother or her offspring.
Moore
H C
HC
Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. mooreh1@ccf.org
D000328:Adult; D000367:Age Factors; D000568:Amenorrhea / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006304:Health Status; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced*; D008593:Menopause; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced* / Q000517:prevention & control; D013629:Tamoxifen / Q000009:adverse effects / Q000627:therapeutic use
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen