BREAST CANCER

Fertility drugs do not increase breast cancer risk

Fertility drugs do not increase breast cancer risk

Drugs routinely used during fertility treatments to release eggs do not increase the risk of developing breast cancer, new research has shown.

Researchers from King’s College London, in partnership with King’s Fertility, analysed studies involving 1.8 million women undergoing fertility treatments. These women were followed up in studies for an average period of 27 years and had no increase in the risk of developing breast cancer.

The research, published in Fertility and Sterility journal, is the largest study to date assessing whether commonly used fertility drugs are for a cancer risk for women.

Fertility treatments can range from using medications to boost the release of an egg in a women’s natural cycle to more complex treatment such as IVF which involves stimulating a patient’s ovarian cycle, extracting eggs from their ovaries, fertilising them with sperm in a laboratory, then transferring the embryo into the womb to develop.

Fertility drugs to stimulate ovaries to release eggs have been used to treat infertility since the early 1960s. Drugs that are used to stimulate the ovaries increase oestrogen hormone production and can act on breast cells. There has been concern that this could turn the cells cancerous, which has led to an uncertainty about the potential risk of infertility drugs causing breast cancer.

The review looked at studies from 1990 to January 2020. Women of all reproductive ages were included in this study and followed up for an average of 27 years following their fertility treatment. ‘Researchers found no significant increase in risk to women exposed to treatment versus untreated women, and untreated women who were infertile.

Study author Dr Yusuf Beebeejaun from King’s College London and King’s Fertility said: “Fertility treatment can be an emotional experience. Patients often ask us if taking ovarian stimulating drugs will put them at increased risk of developing cancers, including breast cancer. To answer that important clinical question, we undertook this review that reports data from nearly 2 million people.”

Dr Sesh Sunkara, senior-author of the paper, from King’s College London and King’s Fertility said ”Our study showed that the use of drugs to stimulate ovaries in fertility treatment did not put women at increased risk of breast cancer. This study provides the evidence needed to reassure women and couples seeking fertility treatments.”

Katy Lindemann, a patient advocate with lived experience of fertility treatment said: “So much of the fear, stress and anxiety associated with fertility treatment is rooted in navigating uncertainty. This study not only gives patients peace of mind at an emotional level, but also enables us to make more informed decisions about treatment risks and benefits at a rational level.”

Dr Kotryna Temcinaite, Senior Research Communications Manager at Breast Cancer Now, said: “Each year around 55,000 UK women get the terrible news that they have breast cancer. We urgently need to learn more about what factors contribute to someone’s risk of developing the disease and stop women dying from breast cancer.

“Previously it was unclear whether fertility drugs affect breast cancer risk, and we do receive calls to our Helpline from women who are concerned that their breast cancer has been caused by fertility treatment. While this analysis of existing published studies does provide welcome reassurance that fertility treatment is unlikely to increase breast cancer risk, further long-term and detailed studies are now needed to confirm these findings.

 

Read more: https://www.fertstert.org/article/S0015-0282(21)00077-7/fulltext

 

Fertility preservation is effective in female cancer patients

Fertility preservation is effective in female cancer patients

The largest study looking at long-term outcomes of fertility preservation in female cancer patients has demonstrated how successful it can be, in particular for breast cancer patients.

The research, presented at the virtual meeting of the European Society of Human Reproduction and Embryology 2020 followed 879 young female patients (mean age 33.8) over a period of 19 years (2000-2019) – the longest reported follow-up of fertility preservation in cancer patients.

‘Currently, there is limited long-term outcome data [on fertility preservation] and this makes it difficult to counsel patients about the likelihood of success.’ said study author Dr Dalia Khalife from Guy’s and St Thomas’ Hospital, London. ‘Our study offers the largest cohort and longest follow-up of fertility preservation in female cancer patients… Around one in six of those who stored their gametes had a good outcome.’

However, she noted that there is a need for longer follow-up of patients and that early referral for fertility treatment is vital.

After counselling, 373 patients (42 percent) chose to have fertility preservation using one of three fertility preservation techniques: egg freezing (53 percent), embryo freezing (41 percent) and ovarian tissue cryopreservation (1%); with 5% using both egg and embryo freezing.

A total of 61 patients (16.4 percent) returned to use their eggs and 44 of them were successful following fertility treatment (live birth rate 72.1 percent).

Women diagnosed with breast cancer were the most likely to return for treatment and also had the highest live birth rate (70 percent versus 30 percent for lymphoma patients).

‘A fertility preservation service must be integral to a modern cancer care pathway. Fertility preservation with eggs and embryos has been beyond experimental for some time. And it’s important that clinicians across the world continue to collect and share data on long-term outcome for all methods, including ovarian tissue preservation, to provide patients with robust information’ said Dr Khalife.

Commenting on the study, Dr Melanie Davies, consultant obstetrician and gynaecologist at University College London Hospitals NHS trust and chair of Fertility Preservation UK, :

‘This is fantastic news – proof positive that fertility preservation is effective and worthwhile. It gives excellent outcomes for those women who return to use frozen eggs/embryos, as 44 of 61 achieved successful pregnancies and births. The proportion of patients who came back to the fertility clinic to use their frozen eggs/embryos (16 percent) is notably higher than for men who store sperm. More will return as the years pass. These results confirm that young women with a new diagnosis of cancer should be offered fertility preservation as part of their treatment pathway as long as they are well enough and time allows.’

Read more: https://www.eshre.eu/ESHRE2020/Media/2020-Press-releases/Khalife

Breastfeeding for cancer prevention

Breastfeeding for cancer prevention

One of the many benefits of breastfeeding is that it can lower a mother’s risk of some cancers.

Most people know there are many benefits to breastfeeding. We’ve probably all heard that it’s the best source of nutrition for most babies and provides many health benefits for infants.

The health benefits for women who breastfeed, however, are less commonly known. In addition to lowering a mother’s risk for type 2 diabetes and high blood pressure, breastfeeding can also lower a mother’s risk of breast and ovarian cancers.

A recent study found that only about 1 in 4 people think that a woman is less likely to develop breast cancer later in life if she breastfeeds. It’s important to know that breastfeeding helps not only the baby’s health but also the mother’s health too.

The American Academy of Pediatrics (AAP) recommends that infants be exclusively breastfed for about the first 6 months of life with continued breastfeeding after the introduction of solid foods for 1 year or longer.

Although most infants receive some breast milk, most are not exclusively breastfed or continue to breastfeed as long as recommended. Four out of 5 infants start out breastfeeding, but only 1 in 4 infants are still exclusively breastfed at 6 months.

Breastfeeding is important for overall health. Infants that are breastfed have a lower risk of asthma, obesity, ear and respiratory infections, sudden infant death syndrome, and gastrointestinal infections such as diarrhea.

One reason breastfeeding lowers the risk of cancer may be that when a woman is breastfeeding, she experiences hormonal changes that may delay the return of her menstrual periods. This reduces her lifetime exposure to hormones such as estrogen, which are linked to an increased risk of breast and ovarian cancers.

According to researchers a human milk complex of alpha-lactalbumin and oleic acid (HAMLET) induces apoptosis only in tumour cells, while normal differentiated cells are resistant to its effects, thus providing safe and effective protection against the development of breast cancer. The longer a mother breastfeeds and the more children she breastfeeds in her life, the higher the protection she gets. Breastfeeding for as few as 3 months is associated with reduced ovarian cancer risk. If the mother breastfeeds for at least 13 months, the risk of getting ovarian cancer is 63% lower.

Source: https://blogs.cdc.gov/cancer/2019/08/01/breastfeeding-for-cancer-prevention/

https://www.ncbi.nlm.nih.gov/pubmed/23317179

https://www.sciencedirect.com/science/article/pii/S0090825819300605

https://academic.oup.com/ajcn/article/97/2/354/4577063?sid=a32809e9-b5ea-485b-ae4e-1b919e703338

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