Ovarian ablation for premenopausal breast cancer: A review of treatment considerations and the impact of premature menopause

2017 ◽  
Vol 55 ◽  
pp. 26-35 ◽  
Author(s):  
Melica Nourmoussavi ◽  
Gary Pansegrau ◽  
Jason Popesku ◽  
Geoffrey L. Hammond ◽  
Janice S. Kwon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Premature Menopause ◽  
Premenopausal Breast Cancer ◽  
Ovarian Ablation ◽  
Treatment Considerations ◽  
The Impact

Amenorrhea in Premenopausal Women After Adjuvant Chemotherapy for Breast Cancer

2006 ◽  
Vol 24 (36) ◽  
pp. 5769-5779 ◽  
Author(s):  
Janice M. Walshe ◽  
Neelima Denduluri ◽  
Sandra M. Swain
Keyword(s):  
Breast Cancer ◽  
Comprehensive Evaluation ◽  
Premenopausal Women ◽  
Outcome Analysis ◽  
Premature Menopause ◽  
Ovarian Ablation ◽  
Hormone Receptor Positive ◽  
Direct Cytotoxicity ◽  
Dual Mechanism ◽  
The Impact

Chemotherapy and ovarian ablation both independently improve survival in premenopausal women with hormone-sensitive breast cancer. Amenorrhea is a well-recognized occurrence after chemotherapy. The rate of chemotherapy-induced amenorrhea varies with patient age and chemotherapy regimens administered. However, the impact of chemotherapy-induced amenorrhea on prognosis is still being defined. Older studies in premenopausal women argue that the benefit with chemotherapy is a result of direct cytotoxicity alone. However, studies that restrict outcome analysis to hormone receptor–positive tumors suggest that chemotherapy has a dual mechanism in women with hormone-responsive tumors; indirect endocrine manipulation secondary to chemotherapy-induced ovarian suppression and direct cytotoxicity. The significant health ramifications involved with the induction of premature menopause as well as potential benefits necessitate a comprehensive evaluation of chemotherapy-induced amenorrhea. This review will discuss the incidence of amenorrhea with commonly-used adjuvant chemotherapeutic regimens, the possible benefits of chemotherapy-induced amenorrhea, and the challenges of interpreting the existing data in breast cancer trials.

Results from London Regional Clinical Genetics services over a 5-year period on germline TP53 testing in women diagnosed with breast cancer at <30 years

2021 ◽  
pp. jmedgenet-2021-107742
Author(s):  
Alice Garrett ◽  
Sabrina Talukdar ◽  
Louise Izatt ◽  
Angela F Brady ◽  
Sinead Whyte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Pathogenic Variant ◽  
Her2 Status ◽  
Clinical Genetics ◽  
Premenopausal Breast Cancer ◽  
Genetic Test Results ◽  
Genetics Services ◽  
Clinical Genetics Services ◽  
The Impact

BackgroundThe most common cancer diagnosed in germline TP53 pathogenic variant (PV) carriers is premenopausal breast cancer. An increased rate of breast tumour HER2 positivity has been reported in this group. Screening for breast/other cancers is recommended in PV carriers.Objectives1. To assess the frequency of germline TP53 PVs reported diagnostically in women with breast cancer at <30 years of age.2. To evaluate the impact of personal/family history and HER2 status on the likelihood of germline TP53 pathogenic/likely pathogenic variant (PV/LPV) identification.MethodsGenetic test results from patients undergoing diagnostic germline TP53 tests between 2012 and 2017 in the four London Regional Clinical Genetics Services were reviewed. Clinical/pathology data and family history were extracted from genetics files for women diagnosed with breast cancer at <30 years.ResultsThe overall germline TP53 PV/LPV variant detection rate was 9/270=3.3% in all women diagnosed with breast cancer at <30 years and 2/171=1.2% in those with no second/subsequent cancer diagnosis or family history of TP53-spectrum cancers. Breast cancers were significantly more likely to be HER2-positive in TP53 PV/LPV carriers than in non-carriers (p=0.00006).ConclusionsGermline TP53 PVs/LPVs are uncommon among women diagnosed with breast cancer aged <30 years without other relevant personal or family cancer history but have an important clinical impact when identified.

Impact of breast cancer and BRCA mutations on thoughts and feelings of future pregnancies.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 38-38
Author(s):  
Ashley Henriksen Woodson ◽  
Kimberly I. Muse ◽  
Michelle Jackson ◽  
Banu Arun ◽  
Jennifer Keating Litton
Keyword(s):  
Breast Cancer ◽  
Mutation Carrier ◽  
Brca Mutation ◽  
Brca Mutation Carrier ◽  
Brca Mutations ◽  
Premenopausal Breast Cancer ◽  
Future Child ◽  
Future Pregnancy ◽  
Answer Choice ◽  
The Impact

38 Background: Many women diagnosed with premenopausal breast cancer are concerned with treatment-related infertility. Identifying a BRCA mutation associated with hereditary breast and ovarian cancer may affect attitudes regarding future childbearing. We evaluated attitudes regarding the impact of cancer or potentially being a BRCA mutation carrier on future childbearing. Methods: Women with childbearing potential were invited to participate in an IRB-approved questionnaire study administered prior to genetic counseling and after results disclosure, if applicable. Women were provided a series of 15 statements and asked to rate how often they thought about the impact of cancer or of having a BRCA mutation on the ability to conceive or carry a pregnancy on a 4-point scale ranging from not at all to often. Descriptive statistics were used. Results: We received 148 pre-questionnaires and 114 post-questionnaires. Thirteen women tested positive for a BRCA 1 mutation and 5 with a BRCA 2 mutation. The mean age was 35 (range 20-45) with 71% having breast cancer. The majority (62%) had at least 1 biological child prior to diagnosis and 45% desired a future child. Across 15 statements, 57% of women did not have any thoughts or feelings about the impact of cancer or a BRCA mutation on a future pregnancy at initial visit. Across the same 15 statements, 52% of women who tested positive for a BRCA mutation changed their answer from the pre-questionnaire to post-questionnaire. Of these women, 70% thought about the impact more often than they reported initially. When compared to women who tested negative for a BRCA mutation (n=78), only 40% of women changed their answer choice, with 54% thinking about the impact less often. Conclusions: Women testing positive for a BRCA mutation were more likely to have an increase in thoughts and feelings regarding the impact of cancer or of being a BRCA mutation carrier on the ability to have a future pregnancy, while women who tested negative showed a decrease. Therefore, women with a BRCA mutation may be influenced in their decisions regarding future childbearing.

Long-term consequences of ovarian ablation for premenopausal breast cancer.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e11559-e11559
Author(s):  
Janice S Kwon ◽  
Gary K. Pansegrau ◽  
Melica Nourmoussavi ◽  
Geoffrey L Hammond ◽  
Mark Stafford Carey
Keyword(s):  
Breast Cancer ◽  
Premenopausal Breast Cancer ◽  
Ovarian Ablation ◽  
Long Term Consequences

Long-term consequences of ovarian ablation for premenopausal breast cancer

2016 ◽  
Vol 157 (3) ◽  
pp. 565-573 ◽  
Author(s):  
Janice S. Kwon ◽  
Gary Pansegrau ◽  
Melica Nourmoussavi ◽  
Geoffrey Hammond ◽  
Mark S. Carey
Keyword(s):  
Breast Cancer ◽  
Premenopausal Breast Cancer ◽  
Ovarian Ablation ◽  
Long Term Consequences

scholarly journals Major Depression in Breast Cancer Patients with Ovarian Function Suppression: A Cross-Sectional Study Comparing Ovarian Ablation and Gonadotropin-Releasing Hormone Agonists

2021 ◽  
Author(s):  
Junhan Jiang ◽  
Junnan Xu ◽  
Li Cai ◽  
Li Man ◽  
Limin Niu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Major Depression ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Cancer Patients ◽  
Gonadotropin Releasing Hormone ◽  
Breast Cancer Patients ◽  
Premenopausal Breast Cancer ◽  
Releasing Hormone ◽  
Ovarian Ablation

Abstract Purpose: We examined whether there were differences in major depression outcomes and independent risk factors associated with gonadotropin-releasing hormone agonists (GnRHa) and ovarian ablation (OA) in premenopausal breast cancer patients. Methods: Premenopausal breast cancer patients from seven hospitals who received OFS participated in the study between June 2019 and June 2020. The independent variable was the type of ovarian suppression, categorized as either OA (n = 174) or GnRHa (n = 389). Major depression was evaluated using the Patient Health Questionnaire (PHQ-9), and the Female Sexual Function Index questionnaire was used to assess sexual function.Results: A total of 563 patients completed the surveys. The mean PHQ-9 sum score was slightly lower in the GnRHa cohort than in the OA cohort (11.4 ± 5.7 vs. 12.8 ± 5.8, P = 0.079). There were significantly fewer patients with major depression (PHQ-9 ≥ 15) in the GnRHa cohort (31.1% vs. 40.2%, P = 0.025). Further, the duration of OFS was closely correlated with major depression, indicating a time-dependent trend [duration of OFS > 2 years vs. duration of OFS ≤ 2 years: Exp (B) = 1.651, P = 0.031]. Sexual dysfunction was negatively correlated with major depression [sexual dysfunction vs. normal: Exp (B) = 0.769, P = 0.046].Conclusions: This is the first study to demonstrate that GnRHa results in more favorable depression outcomes than OA. Moreover, most patients preferred alternatives to their OFS treatment. These findings can contribute to improving and alleviating the adverse effects of OFS.

scholarly journals Association between serum lipids and breast cancer risk in premenopausal women: systematic review and meta-analysis

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110610
Author(s):  
Jing Wu ◽  
Xun Lei ◽  
Xianjun Pan ◽  
Xiaohua Zeng ◽  
Wei Li
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Publication Bias ◽  
Serum Lipids ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Premenopausal Breast Cancer ◽  
The Impact

Objective Associations between serum lipids and their individual components with premenopausal breast cancer risk are unclear. This meta-analysis summarized the literature on serum lipids and premenopausal breast cancer risk to elucidate their relationship. Methods Eligible studies were identified by searching the PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases until 31 December 2020. Standardized mean difference (SMD) scores with 95% confidence intervals (95%CIs) were used to assess the impact of serum lipids on premenopausal breast cancer risk. The I2 statistic was calculated to measure the percentage of heterogeneity, and Egger’s test was performed to measure publication bias. Results Thirteen studies were included. The SMD scores of triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were 12.90 (95%CI: 7.19–18.61) and 31.43 (95%CI: 8.72–54.15), respectively. The SMD scores of total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were not significantly different between the groups. The included studies were highly heterogeneous. There were no publication biases found in TC, LDL-C, or HDL-C analyses, whereas publication bias was present in the TG analysis. Conclusions TG and LDL-C were higher in premenopausal breast cancer patients than in women without breast cancer. However, no significant differences were found in TC or HDL-C levels.

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