Breast Cancer, Fertility Preservation and Reproduction Nicoletta Biglia Fedro Alessandro Peccatori Editors 123
Breast Cancer, Fertility Preservation and Reproduction
Nicoletta Biglia Fedro Alessandro Peccatori Editors Breast Cancer, Fertility Preservation and Reproduction
Editors Nicoletta Biglia Department of Obstetrics and Gynaecology University of Torino School of Medicine Mauriziano Umberto I Hospital Torino Italy Fedro Alessandro Peccatori Fertility and Procreation Unit Istituto Europeo di Oncologia Milano Italy ISBN 978-3-319-17277-4 DOI 10.1007/978-3-319-17278-1 ISBN 978-3-319-17278-1 (ebook) Library of Congress Control Number: 2015939681 Springer Cham Heidelberg New York Dordrecht London Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
Foreword The incidence of breast cancer in young and premenopausal women is increasing in Europe and in the USA. At the same time, a trend towards delaying pregnancy to later in life has been observed and many women will receive a diagnosis of breast cancer before completing their families. Although a diagnosis of cancer is distressing at any age, in young women it is fraught with several unique challenges including its impact on reproduction. Women with a history of breast neoplasm should be given the possibility to conceive and get mother, particularly if they have not completed their planned family. Thanks to advances in early diagnosis and treatment, the cure rate at present is very high and many young women will ask to their gynaecologists and oncologists a great many questions about the feasibility and safety of attempting a pregnancy after breast cancer. Will pregnancy eventually impair my prognosis? When can I start trying and get pregnant? Is it mandatory to carry on the endocrine treatment up to the scheduled end? What is the impact of chemotherapy? Are there any risks for the newborn? Do I have a higher risk of abortion because of my disease? Will I be able to breastfeed? And many more. Nicoletta Biglia and Fedro Peccatori with this book provide us invaluable state-of-the-art answers to the above questions, but this is only the tip of the iceberg. They raise and discuss many more points. Fertility preservation is among the most prominent ones, because it requires a prompt decision and shifts the time for dealing with the problem from the end of the treatment to a short time window before starting chemotherapy. The advent of assisted reproduction techniques within the oncology field has made fertility preservation a viable option, but several studies have shown that fertility counselling remains inadequate and lacks of a standardised approach. In clinical practice, gynaecologists and oncologists are frequently faced with women who need to be thoroughly informed about the available fertility preservation techniques but, possibly because of a kind of discomfort and lack of knowledge, eventually leave fertility concerns poorly addressed. v
vi Foreword This book will provide them with the most updated scientific knowledge on this subject and hopefully will motivate them to be proactive in addressing the fertility preservation issue. Finally, the authors bring to our attention and discuss in depth a new and fascinating challenge, for those of us dealing everyday with young women with breast cancer: the debated issue of fertility preservation and preimplantation genetic diagnosis in BRCA mutation carriers. I am proud of having stimulated the authors to edit this book! Turin, Italy Piero Sismondi
Contents 1 Epidemiology of Breast Cancer in Young Women.................. 1 Fabio Parazzini, Antonella Villa, Giampiero Polverino, Stefania Noli, and Giovanna Scarfone 2 Managing Breast Cancer in Young Women...................... 11 Joyce G. Habib and Hatem A. Azim Jr. 3 Impact of Breast Cancer Treatment on Fertility.................. 29 Lorenzo Rossi and Olivia Pagani 4 Fertility Preservation, ART, and Breast Cancer.................. 45 Alberto Revelli, Francesca Salvagno, Simona Casano, Luisa Delle Piane, and Chiara Benedetto 5 Breast Cancer During Pregnancy.............................. 61 Giovanni Codacci-Pisanelli, Giovanna Scarfone, Lino Del Pup, Eleonora Zaccarelli, and Fedro A. Peccatori 6 Pregnancy After Breast Cancer................................ 71 Nicoletta Biglia, Nicoletta Tomasi Cont, Valentina Bounous, Marta d Alonzo, and Silvia Pecchio 7 Reproductive Issues in BRCA Mutation Carriers................. 83 Shani Paluch-Shimon, Dror Meirow, and Jordana Hyman vii
Epidemiology of Breast Cancer in Young Women 1 Fabio Parazzini, Antonella Villa, Giampiero Polverino, Stefania Noli, and Giovanna Scarfone Breast cancer is the most frequent cancer among women and it is the second leading cause of cancer death around the world. It is the most commonly diagnosed cancer in women between the ages of 25 and 39 (CANCERMondial http://ci5.iarc.fr/ CI5plus/ci5plus.htm ). Breast cancer cases observed in young women have some clinical epidemiological and genetic characteristics that differ from those observed among older ones. Breast cancer in young women has an aggressive course of clinical presentation [ 1 ], a higher rate of germline mutation in BRCA 1&2 [ 2 ], distinct estrogen and progesterone receptor expression, and over-expression of human epidermal growth factor receptor 2 (HER2) [ 3, 4 ]. Further, they are different also in the epidemiological profile. In this chapter, we reviewed the epidemiology of breast cancer among women aged 40 years or less. 1.1 Frequency In the USA, the SEER report estimates the risk of developing breast cancer in 10-year age intervals. According to the current report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the age of 30 is 1 in about 230 ( www.cancer.gov/cancertopics ). The incidence rate of breast cancer among women aged 20 24 years in the USA is 1.5 cases per 100,000 women and about 50 per 100,000 women among women F. Parazzini (*) A. Villa G. Polverino S. Noli G. Scarfone Dipartimento di Scienze Cliniche e di Comunità, Dipartimento Materno Infantile, IRCCS Policlinico, Università di Milano, Via Commenda 12, 20122 Milan, Italy e-mail: fabio.parazzini@unimi.it; giovanna.scarfone@unimi.it; antonella.villa@unimi.it; giampiero.polverino@unimi.it Springer International Publishing Switzerland 2015 N. Biglia, F.A. Peccatori (eds.), Breast Cancer, Fertility Preservation and Reproduction, DOI 10.1007/978-3-319-17278-1_1 1