Study: Fertility Preservation Measures Do Not Increase Risk of Breast Cancer Recurrence

Women with breast cancer who undergo procedures for fertility preservation are not at an increased risk of recurrence of the disease or disease-specific mortality, according to the results of a study published in JAMA Oncology.

Investigators from the Karolinska Institutet in Sweden hope that the results could provide hope and safety to women who want to preserve their fertility after cancer treatment with chemotherapy.

Methods to preserve fertility include cryopreservation, which is the freezing of embryos, female gametes (ooytes), and ovarian tissue.

“It is not unusual that women with hormone-positive breast cancer, or their treating doctors, opt out of the procedures for fertility preservation, because of the fear that these procedures will increase the risk of cancer recurrence or death. In some cases, women are also advised to wait 5 to 10 years before trying to conceive, and with increasing age, fecundity in all women decreases, Anna Marklund, researcher at the Department of Oncology-Pathology at the Karolinska Institutet, said in a statement.

“More knowledge is therefore needed about the safety of procedures for fertility preservation at the time of a breast cancer diagnosis,” she said.

In the study, investigators wanted to determine if procedures for fertility preservation were related to an increased risk of breast cancer recurrence or death.

They included 1275 women of childbearing age who were treated for breast cancer between 1994 and 2017 in Sweden and were followed for an average of 5 years. Four hundred and twenty-five individuals underwent procedures for fertility preservation, with or without hormonal stimulation, and 850 women were treated for breast cancer but did not undergo procedures for fertility preservation.

Investigators matched the women in both groups on age at diagnosis, calendar period at diagnosis, and health care region. The data were taken from nationwide health care registers and population registers with data on disease- and treatment-related variables, outcomes, and socio-economical characteristics.

Over the 5 years, the percentage of women without relapse was 89% for those who underwent hormonal stimulation of the ovaries, 83% for those with ovarian tissue freezing, and 82% for those who did not undergo procedures for fertility preservation.

The survival rate over the 5-year period was 96% for those who underwent hormonal stimulation to freeze eggs or embryos, 93% for those who underwent procedures for fertility preservation but did not undergo hormone stimulation, and 90% for those who did not undergo procedures for fertility preservation.

“We did not see any increased risk of relapse or mortality when procedures for fertility preservation were undertaken compared to the women who did not undergo procedures for fertility preservation. This is valuable information that can contribute to changed care routines when it comes to young women with breast cancer who want to preserve their fertility,” Kenny Rodriguez-Wallberg, adjunct professor at the Department of Oncology-Pathology, Karolinska Institutet, said in the statement.

The investigators plan to follow up on the results after another 5-year period.

Reference

Fertility preservation measures do not appear to increase the risk of breast cancer recurrence. News release. EurekAlert. August 25, 2022. Accessed August 26, 2022. https://www.eurekalert.org/news-releases/962880