Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility
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2011-09-01
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Infertility represents one of the main long-term consequences of combination chemotherapy used for the treatment of breast cancer. Approximately 60%-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ tumors with respect to recurrence-free survival and overall survival, Presentation of the hypothesis: It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. Testing the hypothesis: Assessment of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen. The recurrence-free survival and overall survival should be analysed. Implications of the hypothesis: The major implication will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.
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Adjuvant therapy, Breast cancer, Chemotherapy, Fertility preservation, GnRHa, Hormone receptor-positive, Tamoxifen, Cyclophosphamide, Fluorouracil, Follitropin, Gonadorelin agonist, Hormone receptor, Inhibin B, Methotrexate, Muellerian inhibiting factor, Tamoxifen, Adjuvant therapy, Amenorrhea, Breast cancer, Disease association, Disease free survival, Fertility, Human, Hypergonadotropism, Ovarian reserve, Ovary function, Ovary insufficiency, Overall survival, Reproduction
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Jornal Brasileiro de Reproducao Assistida, v. 15, n. 5, p. 39-43, 2011.
