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Villarreal-Garza C, Mesa-Chavez F, Plata de la Mora A, et al. Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico. J Natl Compr Canc Netw. 2021;1-8doi: 10.6004/jnccn.2020.7692.
Villarreal-Garza, C., Mesa-Chavez, F., Plata de la Mora, A., Miaja-Avila, M., Garcia-Garcia, M., Fonseca, A., de la Rosa-Pacheco, S., Cruz-Ramos, M., García Garza, M. R., Mohar, A., & Bargallo-Rocha, E. (2021). Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico. Journal of the National Comprehensive Cancer Network : JNCCN, 1-8. https://doi.org/10.6004/jnccn.2020.7692
Villarreal-Garza, Cynthia, et al. "Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico." Journal of the National Comprehensive Cancer Network : JNCCN vol. (2021): 1-8. doi: https://doi.org/10.6004/jnccn.2020.7692
Villarreal-Garza C, Mesa-Chavez F, Plata de la Mora A, Miaja-Avila M, Garcia-Garcia M, Fonseca A, de la Rosa-Pacheco S, Cruz-Ramos M, García Garza MR, Mohar A, Bargallo-Rocha E. Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico. J Natl Compr Canc Netw. 2021 Jun 21;1-8. doi: 10.6004/jnccn.2020.7692. Epub 2021 Jun 21. PMID: 34153944.
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J Natl Compr Canc Netw. 2021 Jun 21;1-8. doi: 10.6004/jnccn.2020.7692. Epub 2021 Jun 21.

Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico.

Journal of the National Comprehensive Cancer Network : JNCCN

Cynthia Villarreal-Garza, Fernanda Mesa-Chavez, Alejandra Plata de la Mora, Melina Miaja-Avila, Marisol Garcia-Garcia, Alan Fonseca, Sylvia de la Rosa-Pacheco, Marlid Cruz-Ramos, Manuel Rolando García Garza, Alejandro Mohar, Enrique Bargallo-Rocha

Affiliations

  1. 1Centro de Cancer de Mama, TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon.
  2. 2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico.
  3. 3Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico.
  4. 4Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon.
  5. 5Instituto de Ginecologia, TecSalud, Tecnologico de Monterrey, Monterrey, Nuevo Leon; and.
  6. 6Unidad de Epidemiologia e Investigacion Biomedica en Cancer, Instituto Nacional de Cancerologia, and.
  7. 7Instituto de Biomedicas, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, México.

PMID: 34153944 DOI: 10.6004/jnccn.2020.7692

Abstract

BACKGROUND: Despite the risk of treatment-related infertility, implementation of fertility-preservation (FP) strategies among young patients with breast cancer is often suboptimal in resource-constrained settings such as Mexico. The "Joven & Fuerte: Program for Young Women With Breast Cancer" strives to enhance patient access to supportive care services, including FP measures through alliances with assisted-reproduction units and procurement of coverage of some of these strategies. This study describes patients from Joven & Fuerte who have preserved fertility, and assesses which characteristics were associated with the likelihood of undergoing FP.

METHODS: Women aged ≤40 years with recently diagnosed breast cancer were prospectively accrued. Sociodemographic and clinicopathologic data were collected from patient-reported and provider-recorded information at diagnosis and 1-year follow-up. Descriptive statistics, chi-square test, and simple logistic regression were used to compare patients who preserved fertility with those who did not.

RESULTS: In total, 447 patients were included, among which 53 (12%) preserved fertility, representing 38% of the 140 women who desired future biologic children. Oocyte/embryo cryopreservation was the most frequently used method for FP (59%), followed by temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy (26%), and use of both GnRHa and oocyte/embryo cryopreservation (15%). Younger age, higher educational level, being employed, having private healthcare insurance, and having one or no children were associated with a significantly higher likelihood of preserving fertility.

CONCLUSIONS: By facilitating referral and seeking funds and special discounts for underserved patients, supportive care programs for young women with breast cancer can play a crucial role on enhancing access to oncofertility services that would otherwise be prohibitive because of their high costs, particularly in resource-constrained settings. For these efforts to be successful and widely applied in the long term, sustained and extended governmental coverage of FP options for this young group is warranted.

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