Maintaining fertility in young women with breast cancer.
Maintaining fertility in young women with breast cancer.
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DOI：
10.1007/s11864-010-0116-2
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发表时间：
2009-12
影响因子：
4.3
通讯作者：
Jeruss, Jacqueline S.
中科院分区：
文献类型：
--
作者：
Hulvat, Melissa C.;Jeruss, Jacqueline S.
乳腺癌每年影响近20万美国女性，其中9%的女性仍处于育龄阶段。对于这部分未来的幸存者来说，生育率问题可能是一个重要的生活质量问题。照顾年轻乳腺癌患者的多学科团队必须彻底了解年轻乳腺癌患者不孕不育的原因和治疗方法，以便护理人员成为患者的有效倡导者。放射治疗、细胞毒性化疗和激素治疗都或多或少地影响卵巢功能，在50岁或50岁以下的乳腺癌患者接受系统治疗后，永久性闭经的发生率估计在33%到76%之间。在卵母细胞、胚胎和卵巢组织的成功保存方面，生育力保存的科学继续经历着重大的进步，至关重要的是，医生和患者都意识到了可用的生育力保存选择。在年轻患者中处理与治疗相关的不孕症的可能性和应对这一问题的战略的最佳时间是在治疗之前，而不是在癌症治疗开始之后，充分了解现有技术是进行知情讨论的先决条件。卵巢抑制的原因和治疗的选择，包括考虑植入前的遗传诊断和替代的父母方法也被讨论，以帮助临床医生照顾年轻的癌症患者。
Breast cancer effects nearly 200,000 American women each year, with 9% of these women still in their childbearing years. For this subset of future survivors, the issue of fertility may be a significant quality-of-life concern. Both the causes and treatments for infertility in young breast cancer patients must be thoroughly understood by the multidisciplinary team caring for these women in order for the caregivers to be effective advocates for their patients. Radiation, cytotoxic chemotherapy, and hormonal therapy all effect ovarian function to greater or lesser degrees, with the incidence of permanent post-treatment amenorrhea following systemic treatment for breast cancer in women age 50 or younger estimated as between 33% and 76%. The science of fertility preservation continues to experience significant advances in terms of the success of oocyte, embryo, and ovarian tissue preservation, and it is crucial that physicians and patients are aware of the available fertility preservation options. The optimal time to address the possibility of treatment-related infertility and strategies to combat this with younger patients is prior to treatment, rather than after cancer therapy has begun, and a full knowledge of the available technologies is a prerequisite for an informed discussion. Causes of ovarian suppression and options for treatment, including consideration of preimplantation genetic diagnosis and alternative parenting approaches are also discussed to assist the clinician caring for young patients with cancer.
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