A.C.Camargo Next Frontiers

Dados do Resumo


Título

Fertility Preservation Therapy For Breast Cancer Patients: An Integrative Literature Review

Introdução

Breast cancer is a disease characterized by the clonal proliferation of cells in breast tissue. This condition primarily affects women of reproductive age who undergo treatments involving surgery or chemotherapy, which can have a detrimental impact on their fertility. Studies have demonstrated that women receiving these therapies, in combination with Tamoxifen or Letrozole, exhibit a similar income of mature oocytes. Furthermore, oocyte cryopreservation is regarded as a favorable option for fertility preservation.

Objetivo

To analyze safe and effective mechanisms and therapeutic applications for fertility preservation in breast cancer patients.

Métodos

An integrative literature review was conducted. Data collection was performed through an electronic search of journals on the PubMed platform. The descriptors used were sourced from DeCS and MeSH: "fertility preservation," "breast neoplasm," "therapeutics," and "young adult," combined using the boolean operator "AND." Studies from the last five years (2019-2024) were included with the following filters: English language, clinical studies, meta-analyses, and systematic reviews. A total of 12 studies were retrieved and thoroughly reviewed. From these results, 5 studies that best aligned with the proposed theme were selected, while 7 were excluded.

Resultados

Ovarian stimulation (OS) with Tamoxifen and gonadotropic hormones or letrozole results in similar numbers of mature eggs compared to OS with gonadotropic hormones alone. Previous research corroborates these findings, despite the drugs' distinct mechanisms. Studies are still needed to evaluate the long-term effects of these therapies on cancer recurrence and fertility outcomes. The choice of treatment must consider patient preference, side effects, cost and availability. Other approaches include cryopreservation of oocytes, embryos, ovarian cortex and use of stem cells. Ovarian suppression with GnRH and oocyte vitrification are promising but require further study. Recent studies highlight oocyte cryopreservation associated with tamoxifen and letrozole. A study showed that Enrichment and Psychoeducation therapy in Oncofertility can reduce PTSD and improve knowledge and marital relationships.

Conclusões

Random start OS has similar results to those standards and breast cancer does not have a significant impact on the average number of total oocytes in relation to infertile or without comorbidities, and may be affected by malignancy. In cryopreservation techniques, post-defrosting survival rates and cumulative clinical pregnancy favor healthy women. Approaches such as O!PEACE promote stress management, but there is no significant impact on fertility preservation.

Palavras Chave

Breast cancer; fertility preservation; oncofertility

Área

9.Outros (Temas não mencionados acima, Relatos de Casos e Revisão de literatura)

Autores

JÚLIA GOMES RODRIGUES, Gabriel Kwiatkoski, Stephanie Zarlotim Jorge, Manuela Rodrigues Benez, Giovana da Silva Cardoso, Lorrany Eduarda Pereira de Moraes, Ana Beatriz Aparecida Rocha, Munira Sofia Samih Moraes Akl, Marina Felix, Manuela de Oliveira Assis Pastor, Maria Eduarda Geddo Kostakis, Eduardo Henrique Cavalcanti Lira Gomes, Thaís Pesqueira Rodrigues