title: Prevalence and Risk Factors of Ovarian Metastases in Breast Cancer Patients < 41 Years of Age in the Netherlands: A Nationwide Retrospective Cohort Study.
abstract: OBJECTIVE
  Breast cancer is one of the primary indications for cryopreservation and subsequent autotransplantation of ovarian tissue. The safety of this fertility preservation method remains questionable, as the presence of disseminated breast tumor cells cannot yet be excluded in the ovarian autografts. We explored the prevalence of ovarian metastases among young breast cancer patients and determined risk factors for the development of ovarian metastases.
  
  
  METHODS
  Using the nationwide database of the Dutch Pathology Registry (PALGA), we identified a cohort of 2648 women with primary invasive breast cancer at age < 41 years in the period 2000-2010 in the Netherlands who subsequently underwent an oophorectomy. From this source population, all cases who had histologically confirmed ovarian metastases were included. For each case of whom clinical data were available, one control without ovarian metastases who matched the time interval between breast cancer diagnosis and oophorectomy was selected. Data were collected on patient characteristics, diagnosis, treatment and follow-up.
  
  
  RESULTS
  Ovarian metastases were found in 63 out of 2648 patients who met the inclusion criteria. The risk of developing ovarian metastases increased with time passed since breast cancer diagnosis. Multivariate logistic regression analyses showed significant association between tumor stage and the development of ovarian metastases (p = 0.024).
  
  
  CONCLUSIONS
  The prevalence of ovarian metastases was 2.4% among young breast cancer patients. Early ovary removal may reduce the risk of developing ovarian metastases. In breast cancer patients with tumors > 5 cm and/or inflammatory carcinoma, we recommend a cautious approach to ovarian tissue autotransplantation.
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Inge T A
authors.initials: IT
authors.lastname: Peters
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Erik W
authors.initials: EW
authors.lastname: van Zwet
authors.affiliation: Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Vincent T H B M
authors.initials: VT
authors.lastname: Smit
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Gerrit Jan
authors.initials: GJ
authors.lastname: Liefers
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Peter J K
authors.initials: PJ
authors.lastname: Kuppen
authors.affiliation: Department of Gynecology, Reinier de Graaf Hospital, Delft, the Netherlands.
authors.forename: Carina G J M
authors.initials: CG
authors.lastname: Hilders
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: J Baptist
authors.initials: JB
authors.lastname: Trimbos
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D044584:Carcinoma, Ductal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D015925:Cryopreservation; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D016015:Logistic Models; D009367:Neoplasm Staging; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D010052:Ovariectomy; D010053:Ovary / Q000473:pathology / Q000601:surgery* / Q000637:transplantation; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014182:Transplantation, Autologous