Women Who Combine Common Breast Cancer Drugs With Certain Hormones Can Preserve Fertility Without Health Risk, Study Says

Main Category: Breast Cancer
Article Date: 14 Apr 2005 - 11:00 PDT

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Women of reproductive age who have breast cancer can preserve their fertility without increasing their risk of cancer recurrence by taking cancer drugs together with fertility hormones and undergoing in vitro fertilization before chemotherapy, according to a study published on Monday in the online issue of the... Journal of Clinical Oncology, USA Today reports. Although most women with breast cancer require chemotherapy, the drugs often damage the ovaries and leave patients infertile. Hormones are sometimes needed to help women produce enough eggs to undergo IVF and successfully develop embryos, even though taking the hormones can stimulate tumor growth in many women. If IVF is successful, women can preserve the embryos before beginning drug therapy for cancer. Kutluk Oktay, an associate professor of reproductive medicine and obstetrics and gynecology at Weill Medical College of Cornell University in New York, and colleagues studied 60 women ages 24 to 43 who had been diagnosed with breast cancer. Each of the women were studied for an average of 18 months (Szabo, USA Today, 4/12). Of the 60 women, 29 decided to undergo IVF procedures before chemotherapy. The women scheduled to undergo IVF were divided into three treatment groups, based on patient selection and physician input. One group received only the cancer drug tamoxifen; another group received tamoxifen and a low-dose follicle-stimulating hormone, which causes a woman's ovaries to produce more eggs; and a third group received the cancer drug letrozole and a low-dose FSH. Both tamoxifen and letrozole are known to stimulate ovulation without promoting the growth of breast cancer cells, according to HealthDay/Forbes (Doheny, HealthDay/Forbes, 4/12)

Results, Conclusion
Women in the tamoxifen-only group produced an average of 1.3 embryos during IVF, while women taking tamoxifen and FSH produced an average of 3.8 embryos and women taking letrozole and FSH produced an average of 5.3 embryos, according to the study. The researchers also found that breast cancer recurrence rates were similar between the women who underwent IVF and those who did not (Oktay et al., Journal of Clinical Oncology, 4/11). Although most patients involved in the study have not yet tried to become pregnant, one patient is expected to deliver an infant in a few weeks, Oktay said. He recommends that physicians immediately refer breast cancer patients of reproductive age who wish to have children to fertility specialists because IVF takes at least two weeks and chemotherapy usually is started within four to six weeks of surgery after breast cancer diagnosis.

Accompanying Editorial
Ann Partridge, a medical oncologist at Dana-Farber Cancer Institute, and Eric Winer of the Brigham and Women's Hospital in Boston in an accompanying Journal of Clinical Oncology editorial say it is too soon to tell if the procedures studied are safe for women with breast cancer and suggested following the women for several more years, USA Today reports (USA Today, 4/12). They added that the number of women in Oktay's study also was too small to conclude definitively that such techniques are safe (HealthDay/Forbes, 4/12).

"Reprinted with permission from kaisernetwork.org kaisernetwork.org. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/repro The Kaiser Daily Reproductive Health Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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