Pregnancy after breast cancer. A comprehensive review.
ABSTRACT Pregnancy after breast cancer treatment has become an important issue since many young breast cancer patients have not completed their family. Generally, these patients should not be discouraged to become pregnant when they want to, since published data suggest no adverse effect of pregnancy on survival. As fertility may be impaired by chemotherapy, different fertility preserving strategies have been developed. Births seem to sustain no adverse effects, while breastfeeding appears to be feasible and safe.
SourceAvailable from: Ku Sang Kim[Show abstract] [Hide abstract]
ABSTRACT: Despite the fact that more breast cancer survivors are currently enjoying longer lifespans, there remains limited knowledge about the factors and issues that are of greatest significance for these survivors, particularly from their perspectives. This review was based on the concept that the topics addressed should focus on the perspectives of current survivors and should be extended to future modalities, which physicians will be able to use to gain a better understanding of the hidden needs of these patients. We intended to choose and review dimensions other than the pathology and the disease process that could have been overlooked during treatment. The eight topics upon which we focused included: delay of treatment and survival outcome; sexual well-being; concerns about childbearing; tailored follow-up; presence of a family history of breast cancer; diet and physical activity for survivors and their families; qualitative approach toward understanding of breast cancer survivorship, and; mobile health care for breast cancer survivors. Through this review, we aimed to examine the present clinical basis of the central issues noted from the survivors' perspectives and suggest a direction for future survivorship-related research.Journal of Breast Cancer 09/2014; 17(3):189-99. DOI:10.4048/jbc.2014.17.3.189 · 1.32 Impact Factor
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ABSTRACT: CONTEXT: Cancer survival has improved significantly and maintaining fertility is both a major concern and an important factor for the quality of life in cancer patients. AIMS: To explore differences in oocyte stimulation for fertility preservation (FP) patients based on cancer diagnosis. SETTINGS AND DEIGN: Between 2005 and 2011, 109 patients elected to pursue FP at a single institution. MATERIALS AND METHOD: In vitro fertilization (IVF) outcome variables between four cancer diagnostic groups (breast, gynecologic, lymphoma/leukemia and other) and age-matched male factor or tubal factor infertility IVF control group were compared. STATISTICAL ANALYSIS: ANOVA and Chi-square analyses were employed to compare variables between the groups that were normally distributed. Kruskal–Wallis with subsequent Mann–Whitney U-test were used for data that were not normally distributed. RESULTS: Women with gynecologic malignancies were significantly older than the women in the other three groups, but tended to have a better ovarian response. Women with hematologic malignancies were most likely to have been exposed to chemotherapy and had the longest stimulations with a similar number of oocytes retrieved. The age-matched IVF controls had higher peak estradiol levels, number of oocytes obtained, and fertilization rates when compared to cancer patients with or without a history of prior chemotherapy. CONCLUSIONS: Factors including age, type of cancer and chemotherapy exposure, can influence response to ovarian stimulation. Discussing these findings with patients presenting for FP may aid in setting realistic treatment expectations.Journal of Human Reproductive Sciences 04/2014; 7(2):111-8. DOI:10.4103/0974-1208.138869
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ABSTRACT: Breast cancer is one of the most prevalent cancers in females, and 5%-7% of breast cancer cases occur in women under 40 years of age. Breast cancer in the young has gained increased attention with an attempt to improve diagnosis and prognosis. Young patients tend to have different epidemiology, presenting with later stages and more aggressive phenotypes. Diagnostic imaging is also more difficult in this age group. Multidisciplinary care generally encompasses surgeons, medical oncologists, radiation oncologists, radiologists, and social workers. Other special considerations include reconstruction options, fertility, genetics, and psychosocial issues. These concerns enlarge the already diverse multidisciplinary team to incorporate new expertise, such as reproductive specialists and genetic counselors. This review encompasses an overview of the current multimodal treatment regimens and the unique challenges in treating this special population. Integration of diagnosis, treatment, and quality of life issues should be addressed and understood by each member in the interdisciplinary team in order to optimize outcomes.Journal of Multidisciplinary Healthcare 09/2014; 7:419-29. DOI:10.2147/JMDH.S49994