Background/Objectives: Young patients with hormone receptor-positive breast cancer (HR+BC) face an elevated risk of cancer-related mortality, partly due to lower adherence to hormonal therapies for fertilities concerns. This study aims to evaluate fertility preservation in patients receiving hormonal therapy (HT) alone after surgery with or without radiotherapy.Methods: This single-center prospective cohort study evaluated BC patients counseled at the Oncofertility Unit of San Raffaele Hospital (2012–2024).Results: Of 251 BC patients who received counseling, 39 met the inclusion criteria. Among 33 patients with adequate follow-up, 15 (45.5%) are still under anticancer treatment, 6 (18.2%) completed HT but do not seek pregnancy, and 12 (36.3%) sought pregnancy, of which 9 (75%) conceived. Among the nine patients who conceived, four had completed HT (one became pregnant after thawing her cryopreserved oocytes and three had a spontaneous pregnancy). Five patients who conceived had suspended HT to seek pregnancy, according to the results of the POSITIVE trial. After HT discontinuation, all patients thawed their oocytes: three had a pregnancy with a live birth, while two patients did not conceive, so one of them attempted a new in vitro fertilization cycle achieving pregnancy with a live birth, while the other one had a spontaneous pregnancy.Conclusions: Our study highlights the importance of counseling HR+ BC patients candidates for HT alone about the efficacy and safety of fertility preservation. Offering fertility preservation can mitigate the reproductive impact of therapy-related childbearing delays and potentially improve treatment adherence.
背景/目的：激素受体阳性乳腺癌（HR+BC）的年轻患者面临较高的癌症相关死亡风险，部分原因在于因生育顾虑导致激素治疗依从性较低。本研究旨在评估术后仅接受激素治疗（无论是否联合放疗）患者的生育力保存情况。 方法：本项单中心前瞻性队列研究评估了2012年至2024年间在圣拉斐尔医院生育力保存门诊接受咨询的乳腺癌患者。 结果：在251名接受咨询的乳腺癌患者中，39名符合纳入标准。在33名获得充分随访的患者中，15名（45.5%）仍在接受抗癌治疗，6名（18.2%）已完成激素治疗但无妊娠计划，12名（36.3%）有妊娠意愿，其中9名（75%）成功妊娠。在妊娠的9名患者中，4名已完成激素治疗（1名通过解冻冻存卵子后妊娠，3名为自然妊娠）。根据POSITIVE试验结果，另有5名妊娠患者为寻求妊娠而暂停了激素治疗。在暂停激素治疗后，所有患者均解冻了冻存卵子：其中3名通过辅助生殖技术获得活产，2名未成功妊娠（其中1名尝试新一轮体外受精周期后获得活产，另1名最终通过自然妊娠成功）。 结论：本研究强调了向拟接受单纯激素治疗的HR+BC患者提供生育力保存咨询的重要性，阐明其有效性与安全性。提供生育力保存服务可减轻治疗相关生育延迟对生殖健康的影响，并可能提高治疗依从性。
肿瘤(癌症)患者之家