Fertility Preservation: Convergence of Newly Diagnosed Breast Cancer, Desired Fertility, and Polycystic Ovary Syndrome
A 34-year-old nulliparous female presented with a self-discovered 4 cm, firm, mobile mass in the upper, outer quadrant of her right breast. Her mother is a breast cancer survivor, diagnosed at age 45, and was BRCA negative. The patient also had polycystic ovary syndrome based on a long history of irregular menstrual cycles, mild facial and lower abdominal hair, acne, and mild acanthosis nigricans on the nape of the neck. She last used hormonal contraception 4 years prior to initial presentation. Menstrual cycles were more regular in the past year. Current medications to treat anxiety and depression included sertraline, lamotrigine, and oxcarbazepine. She had no other medical illness in the past or at presentation. The patient and her husband were just beginning efforts to become pregnant at the time she discovered her breast mass.
KeywordsOnco-fertility Fertility preservation Breast cancer Polycystic ovary syndrome
- 5.Deemeestere I, Brice P, Peccatori FA, Kentos A, Dupuis J, Zachee P, Casasnovas O, Van Den Neste E, Dechene J, De Maertelaer V, Bron D, Englert Y. No evidence for the benefit of gonadotropin-releasing hormone agonist in preserving ovarian function and fertility in lymphoma survivors treated with chemotherapy: final long-term report of a prospective randomized trial. J Clin Oncol. 2016;34(22):2568–74. https://doi.org/10.1200/JCO.2015.65.8864. Epub 2016 May 23.
- 6.von Wolff M, Stute P. Judging the fertility protective effect of GnRH agonists in chemotherapy – it is a matter of perspective. Front Endocrinol. 2017;8:69.Google Scholar
- 10.Pagani O, Regan MM, Walley BA, Fleming GF, Colleoni M, Láng I, Gomez HL, TEXT and SOFT Investigators, International Breast Cancer Study Group, et al. Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med. 2014;37(2):107–18. https://www.ncbi.nlm.nih.gov/pubmed/?term=Francis PA%5BAuthor%5D&cauthor=true&cauthor_uid=24881463.CrossRefGoogle Scholar
- 12.McLaughlin M, Albertini DF, Wallace WHB, Anderson RA, Telfer EE. Metaphase II oocytes from human unilaminar follicles grown in a multi-step culture system. MHR: Basic Sci Reprod Med. https://doi.org/10.1093/molehr/gay002.
- 13.Cardozo ER, Huber WJ, Stuckey AR, Alvera RJ. Mandating coverage for fertility preservation – a step in the right direction. N Engl J Med. 2017;z377(17):1607–9.Google Scholar