Ovarian stimulation for oocyte vitrification does not modify disease-free survival and overall survival rates in patients with early breast cancer

Reprod Biomed Online. 2019 Nov;39(5):860-867. doi: 10.1016/j.rbmo.2019.07.003. Epub 2019 Jul 10.

Abstract

Research question: Does ovarian stimulation for oocyte vitrification affect disease-free survival and overall survival rates in women with early breast cancer?

Design: This cohort study included 259 patients with early breast cancer; 148 patients underwent ovarian stimulation, whereas 111 patients did not. Patients were treated between January 2008 and December 2016. To calculate the disease-free survival time and overall survival rate, the time of definitive surgery was defined as the starting point. The follow-up was conducted up to 5 years.

Results: Exposed and non-exposed groups were comparable in tumour, node and metastases classification, Nottingham grade, hormonal receptor status, tumour molecular phenotype, histology and pathology stage. The exposed group was younger than the non-exposed. Recurrences occurred in 9/148 women (6.1%) in the exposed group and 15/111 women (13.5%) in the non-exposed group, with no significant difference. The mean disease-free survival time was 63.9 months (95% confidence interval [CI]: 61.5-66.4) in the exposed group and 60.6 months (95% CI: 56.9-64.2) in the non-exposed, with no significant difference (log-rank [Mantel-Cox] test). Overall survival rates were comparable; 2/148 (1.4%) and 4/111 (3.6%) patients died, in exposed and non-exposed groups, respectively, during the period analysed. Mean overall survival times were 67.2 months (95% CI: 66.2-68.2) in the exposed group and 65.9 months (95% CI: 64.0-67.9) in the unexposed, with no significant difference (log-rank [Mantel-Cox] test).

Conclusions: This study suggests that ovarian stimulation in patients with early-stage breast cancer is safe in the long term.

Keywords: Breast cancer; Disease-free survival; Fertility preservation; Ovarian stimulation; Overall survival rate.

MeSH terms

  • Adolescent
  • Adult
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Cryopreservation
  • Disease-Free Survival
  • Female
  • Fertility Preservation / adverse effects*
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Oocytes / cytology*
  • Ovulation Induction / adverse effects*
  • Prospective Studies
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Vitrification*
  • Young Adult