A case of young breast cancer in which delivery was successfully achieved after postoperative chemotherapy under ovarian function protection using GnRH agonist
Shinichiro Kashiwagi, Tsutomu Takashima, Naoki Aomatsu, Hidemi Kawajiri, Naoyoshi Onoda, Tetsuro Ishikawa and Kosei Hirakawa
World Journal of Surgical Medical and Radiation Oncology 2012, 1:19
Breast cancer occasionally occurs in reproductive period. These patients tend to treat with intensive adjuvant or neoadjuvant chemotherapy because of their younger age if cytotoxic chemotherapy is indicated. However, cytotoxic chemotherapy may cause loss of fertility. There are several reports suggesting possibility of ovarian function preservation by administration of GnRH agonist concomitant with cytotoxic chemotherapy.
Herein we report a case of spontaneous delivery after adjuvant chemotherapy using FEC*100 followed by weekly paclitaxel under ovarian protection by GnRH agonist. A 28-year-old woman received a mastectomy due to a right breast cancer. Adjuvant chemotherapy was recommended because of high nuclear grade, younger age and negative hormonal receptor status. However, the patient had the strong hope of pregnancy. GnRH agonist was started prior to chemotherapy due to preventing loss of ovarian function by cytotoxic agents. Four cycles of FEC*100 every 3 weeks followed by 12 cycles of paclitaxel every week with GnRH agonist every 4 weeks was administered. Menstruation was recovered 4 months after ending of chemotherapy. She got pregnant spontaneously 15 months after ending of chemotherapy. And she delivered a 2,825g healthy baby in 40weeks 3days.
Fertility may be preserved by ovarian suppression with GnRH agonist during cytotoxic chemotherapy.
young breast cancer, protection of ovarian function, GnRH agonist.