Breast Cancer Essay: Adjuvant Therapy's Effectiveness Examined

This research essay examines the effectiveness of adjuvant therapy compared to traditional chemotherapy in treating breast cancer, particularly focusing on its impact on fertility preservation. The essay highlights that breast cancer is a common malignancy affecting women and often leads to impaired fertility due to chemotherapy's effects on ovarian function. It argues that adjuvant therapy, especially when combined with chemotherapy, is more efficient in preventing fertility loss. The paper discusses the increased importance of fertility preservation for women undergoing cancer treatment and cites evidence suggesting a higher incidence of birth complications in women with a history of breast cancer treatment. It presents evidence from various studies, including randomized controlled trials and retrospective analyses, demonstrating that adjuvant therapy, particularly hormone-based treatments, can effectively suppress ovarian function during chemotherapy, thereby preserving fertility. The essay concludes that collaboration between oncologists and endocrinologists is crucial for administering hormone-based therapies and that adjuvant therapy offers a significant advantage in resolving fertility-related issues for breast cancer patients.

Running head: RESEARCH ESSAY- BREAST CANCER
Research essay- breast cancer
Name of the student
Name of the university
Author note:

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RESEARCH ESSAY- BREAST CANCER
Introduction:
Breast cancer is the most common malignancy in women of productive age, accounting
for approximately 41% of new cases in Canada 1. Approximately 40% of the women who were
diagnosed with breast cancer are younger than 50years 2. Due to the availability of anticancer
treatments such as chemotherapy, although the younger breast cancer patients become disease
free and healthy it causes a negative impact on the gonad function, which causes the impaired
fertility. However, accumulated evidence suggested adjuvant therapy prior to the chemotherapy
resolved the issue of the chemotherapy. This essay will argue adjuvant therapy with combination
with chemotherapy is efficient than tradition chemotherapy in females with breast cancer.
Therefore, this paper will illustrate the effectiveness of adjuvant therapy over chemotherapy in
the following paragraphs.
Discussion :
Fertility preservation becomes increasingly important for women who survived cancer
along with women who are going through chemotherapy. The available evidence suggested the
occurrence of congenital abnormalities of infants born to women with the history of breast
1 Burstein, Harold J., Christina Lacchetti, and Jennifer J. Griggs. "Adjuvant Endocrine Therapy for Women With
Hormone Receptor–Positive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline
Update on Ovarian Suppression Summary." Journal of oncology practice12, no. 4 (2016): 390-393.
2 Pavone, M., M. B. Moravek, A. K. Lawson, S. Klock, R. Confino, K. N. Smith, and R. R. Kazer. "Fertility
preservation (FP) in breast cancer patients does not delay time to cancer treatment." Fertility and Sterility 108, no. 3
(2017): e184.

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RESEARCH ESSAY- BREAST CANCER
cancer3 . There is a higher incidence of the birth complication observed in the women due to
previous cancer treatment4. Therefore, pregnancy becomes a huge issue even after the survival of
breast cancer. The prime reason behind the phenomenon is that the drugs used in chemotherapy
interrupted the normal cellular processes and causes Oxidative damage of DNA in somatic and
germ line cells that resulted in the loss of fertility in the patient having breast cancer or even after
surviving breast cancer5. However, the study by Dabrosin , most of the women experience
fertility loss as well as after undergoing through the chemotherapy process . According to
Sparano et al. (2018), The older breast cancer is more susceptible to ovarian loss compared
to younger breast cancer patient because of the low ovarian reserve. A quantitative study
reported by Dabrosin (2015),that early menopause in their life if they menstruated during the
session of chemotherapy . A randomized trail control by Dieci et al. (2018), suggested that
this loss could be prevented by using adjuvant therapy with combination with chemotherapy.
This study reported that administration of hormone-based adjuvant therapy prior to the
3 Sparano, Joseph A., Robert J. Gray, Della F. Makower, Kathleen I. Pritchard, Kathy S. Albain, Daniel F. Hayes,
Charles E. Geyer Jr et al. "Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer." New
England Journal of Medicine (2018).
4 Pavone, M., M. B. Moravek, A. K. Lawson, S. Klock, R. Confino, K. N. Smith, and R. R. Kazer. "Fertility
preservation (FP) in breast cancer patients does not delay time to cancer treatment." Fertility and Sterility 108, no. 3
(2017): e184.
5

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RESEARCH ESSAY- BREAST CANCER
chemotherapy prevent the loss of fertility . The Hormonal based therapy prevent the loss of
ovary by suppressing the function of it during the chemotherapy . The study stated that
approximately 85 % of breast cancer patient was benefited by administration the adjuvant
chemotherapy of 50 years or younger than 50 years 6. Two retrospective study was conducted by
that suggested that the data accumulated between 2004-2006 and 2014-2016 shows the positive
impact of the adjuvant therapy over chemotherapy on a patient with breast cancer 7. These two-
cohort studies reported that the fertility issues decreased over the time in the patients due to the
adjuvant therapy 8. Therefore, adjuvant therapy resolved the issue related to pregnancy in breast
cancer patient 9. However, to administrate the hormones in the patient with breast cancer,
collaboration between oncologists and endocrinologists should be followed
Conclusion:
6 Dieci, Maria Vittoria, Cristina Ghiotto, Caterina Barbieri, Gaia Griguolo, Carlo Saccardi, Michele Gangemi,
Alfonso Pluchinotta et al. "Patterns of Fertility Preservation and Pregnancy Outcome After Breast Cancer at a Large
Comprehensive Cancer Center." Journal of Women's Health(2018).
7 Dabrosin, Charlotta. "An overview of pregnancy and fertility issues in breast cancer patients." Annals of
medicine 47, no. 8 (2015): 673-678.
8 Pavone, M., M. B. Moravek, A. K. Lawson, S. Klock, R. Confino, K. N. Smith, and R. R. Kazer. "Fertility
preservation (FP) in breast cancer patients does not delay time to cancer treatment." Fertility and Sterility 108, no. 3
(2017): e184.
9 Dabrosin, Charlotta. "An overview of pregnancy and fertility issues in breast cancer patients." Annals of
medicine 47, no. 8 (2015): 673-678

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RESEARCH ESSAY- BREAST CANCER
Therefore, it can be concluded that breast cancer is considered as one of the common
malignancy in women around the globe that affects the fertility of the women and influenced the
menopause. Although, although the younger breast cancer patients become disease free due to
chemotherapy it causes the impaired fertility. Therefore, adjuvant therapy prior to the
chemotherapy proves to be effective in preventing fertility loss in the patient.

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RESEARCH ESSAY- BREAST CANCER
References :
Burstein, Harold J., Christina Lacchetti, and Jennifer J. Griggs. "Adjuvant Endocrine Therapy for
Women With Hormone Receptor–Positive Breast Cancer: American Society of Clinical
Oncology Clinical Practice Guideline Update on Ovarian Suppression Summary." Journal of
oncology practice12, no. 4 (2016): 390-393.
Dabrosin, Charlotta. "An overview of pregnancy and fertility issues in breast cancer
patients." Annals of medicine 47, no. 8 (2015): 673-678.
Dieci, Maria Vittoria, Cristina Ghiotto, Caterina Barbieri, Gaia Griguolo, Carlo Saccardi,
Michele Gangemi, Alfonso Pluchinotta et al. "Patterns of Fertility Preservation and Pregnancy
Outcome After Breast Cancer at a Large Comprehensive Cancer Center." Journal of Women's
Health(2018).
Pavone, M., M. B. Moravek, A. K. Lawson, S. Klock, R. Confino, K. N. Smith, and R. R. Kazer.
"Fertility preservation (FP) in breast cancer patients does not delay time to cancer
treatment." Fertility and Sterility 108, no. 3 (2017): e184.
Sparano, Joseph A., Robert J. Gray, Della F. Makower, Kathleen I. Pritchard, Kathy S. Albain,
Daniel F. Hayes, Charles E. Geyer Jr et al. "Adjuvant chemotherapy guided by a 21-gene
expression assay in breast cancer." New England Journal of Medicine (2018).