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Method to preserve fertility during breast cancer treatment reported

For women who undergo breast cancer chemotherapy and want to preserve their fertility, a new technique is available that improves the likelihood of them remaining fertile
For women who undergo breast cancer chemotherapy and want to preserve their fertility, a new technique is available that improves the likelihood of them remaining fertile
Robin Wulffson, MD

Most women who develop breast cancer are beyond their child-bearing years; however, a significant number of younger women who develop breast cancer want to preserve their ability to have a child. For these women, a new technique is available that improves the likelihood of them remaining fertile. In addition, the therapy may reduce younger women undergoing premature menopause as a result of the treatment. The results were presented on June 30 at the annual meeting of the American Society of Clinical Oncology, which runs from May 30 through June 3 in Chicago, Illinois.

It is believed that chemotherapy often results in premature ovarian failure, or early menopause, because active ovaries are more susceptible to damage from the treatment. Thus, the researchers thought that forcing them into dormancy and stopping menstruation might prevent the ovaries from damage. The study group comprised 257 women under age 50 with breast cancers whose growth was not increased by estrogen. All the women underwent standard chemotherapy; half also received a monthly injection of goserelin, which is a drug that lowers estrogen levels and forces the ovaries into dormancy. The major symptoms of the drug are menopausal symptoms such as hot flashes and vaginal dryness.

Two years after the onset of the study, complete results were available on 135 women. Only 8% of those given the goserelin injections became menopausal, compared to 22% of the women who did not receive the injections. In addition, among the women in the goserelin group, 22 achieved a pregnancy, compared to 12 pregnancies in the non-goserelin group. The study authors note that the results are encouraging; however, firm comparisons cannot be made because not all women may have been trying to conceive; furthermore, other factors such as a partner's fertility could have played a role.

Another positive finding of the study was that survival was higher among women given goserelin. At four years after treatment, 92% of the women who received goserelin were alive, compared to 82% of the women in the non-goserelin group. The authors cautioned that the size of the study group was too small to determine whether ovarian suppression increased survival.