Focus on breast and ovarian cancer.
In reproductive medicine the widespread use of ovarian stimulation has focused interest on the possible relation between induction of ovulation and breast and ovarian cancer. The epidemiological studies published so far are reassuring but not devoid of methodological problems, such as small populations, short follow-ups, and lack of information on confounding factors like oral contraceptive use. In younger patients to preserve fertility before radio- or chemotherapy, the American Society of Clinical Oncology recommended embryo cryopreservation as an established procedure. Moreover, experimental procedure as oocytes cryopreservation, ovarian suppression with GnRH analogues and cortical ovarian tissue freezing probably will be routinely used in the future. A reasonable proposal to protect patients from the risk of estrogen peaks in the case of estrogen receptor positive (ER+) breast cancer, ovarian stimulation with tamoxifen or letrozole could be right. Powered studies are necessary to control the safety and effectiveness of the different fertility preservation options. In this review we evaluated the relation between induction of ovulation and breast and ovarian cancer and then the possible options for fertility preservation in patients with these types of tumors.
Borini
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Tecnobios Procreazione, Bologna, Italy. borini@tecnobiosprocreazione.it
Rebellato
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E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001943:Breast Neoplasms / Q000209:etiology* / Q000628:therapy; D015925:Cryopreservation / Q000379:methods; D005260:Female; D005298:Fertility / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control; D010051:Ovarian Neoplasms / Q000209:etiology* / Q000628:therapy; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors