Malignant cells are not found in ovarian cortex from breast cancer patients undergoing ovarian cortex cryopreservation.
BACKGROUND
Breast cancer is a frequent indication for ovarian cortex cryopreservation due to its high incidence. The main concern of this procedure is the possibility of reintroducing metastatic cells within the implant, an issue that has not been addressed systematically. Thus, a study was designed to analyse the presence of ovarian metastases in breast cancer patients undergoing ovarian tissue cryopreservation.


METHODS
Morphological and immunohistochemical studies following the concept of the sentinel lymph node (SLN) were performed on 100 cortical ovarian biopsies obtained from 63 patients and on six frozen-thawed entire cortex from patients with the diagnosis of infiltrating ductal breast carcinoma undergoing ovarian cortex extraction and cryopreservation. The antibody panel included Cytokeratin CAM 5.2, Gross Cystic Disease Fluid Protein-15 (GCDFP15), Wilms' tumour antigen-1 (WT1) and Mammaglobin 1.


RESULTS
Employing only morphologic criteria, suspicious neoplastic cells were detected in five biopsies, but in none of the six entire cortex analysed. These five cases were reclassified as hyperplasic surface epithelium-inclusion cysts (CAM 5.2+, WT1+) or apoptotic granulosa cells (CAM 5.2-, GCDFP15+, WT1-).


CONCLUSIONS
Using the methodology of the SLN our data suggest the absence of tumour cells in biopsies obtained from patients undergoing ovarian cortex cryopreservation to preserve their fertility potential, although future methods of cancer screening may change our perception of this procedure.
Sánchez-Serrano
María
M
Department of Obstetrics and Gynaecology, Hospital Universitario Dr Peset, Av Gaspar Aguilar 90, 46017 Valencia, Spain.
Novella-Maestre
Edurne
E
Roselló-Sastre
Esther
E
Camarasa
Natalia
N
Teruel
José
J
Pellicer
Antonio
A
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D002352:Carrier Proteins / Q000032:analysis; D015925:Cryopreservation / Q000379:methods; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D007633:Keratins / Q000032:analysis; D008207:Lymphatic Metastasis / Q000473:pathology; D060785:Mammaglobin A; D026901:Membrane Transport Proteins; D009363:Neoplasm Proteins / Q000032:analysis; D009367:Neoplasm Staging; D010053:Ovary / Q000737:chemistry / Q000166:cytology / Q000473:pathology* / Q000637:transplantation; D016649:Primary Ovarian Insufficiency / Q000209:etiology / Q000628:therapy; D021701:Sentinel Lymph Node Biopsy; D014182:Transplantation, Autologous; D014598:Uteroglobin / Q000032:analysis; D025721:WT1 Proteins / Q000032:analysis
D015415:Biomarkers; C400901:CAM 5.2 antigen; D002352:Carrier Proteins; D006023:Glycoproteins; D060785:Mammaglobin A; D026901:Membrane Transport Proteins; D009363:Neoplasm Proteins; C488892:PIP protein, human; C556448:SCGB2A2 protein, human; D025721:WT1 Proteins; D007633:Keratins; D014598:Uteroglobin