Qualitative Analysis: Adjuvant Therapy for Fertility in Breast Cancer

This presentation analyzes four peer-reviewed qualitative research articles focusing on the effectiveness of adjuvant therapy in restoring fertility in breast cancer patients. The articles explore various aspects, including the use of 21-gene expression assays to guide adjuvant chemotherapy, overviews of pregnancy and fertility issues, patterns of fertility preservation and pregnancy outcomes, and the protective role of luteinizing hormone-releasing hormone analogs during chemotherapy. The analysis highlights the effectiveness of adjuvant therapy in restoring oocytes, preventing early menopause, and improving fertility outcomes over time. Limitations across the studies include insufficient data on chemotherapy-induced menopause, the timing of pregnancy, and reliance on secondary data. The presentation concludes by emphasizing the need for further research and data collection to optimize adjuvant therapy strategies for fertility preservation in breast cancer survivors. Desklib provides additional resources including past papers and solved assignments for further study.

THE USE OF ADJUVANT
THERAPY IN BREAST CANCER
FOR RESTORING FERTILITY.

ARTICLE 1: ADJUVANT CHEMOTHERAPY GUIDED BY A 21-GENE
EXPRESSION ASSAY IN BREAST CANCER.
• Aim : To evaluate whether adjuvant therapy with the combination
of chemotherapy is effective to restore fertility in the breast
cancer survival patient (Sparano et al., 2018)
• Method ( sample and population): a prospective randomized trial
with 10273 women with a positive receptor along with other
factors.
• Result and conclusion : Adjuvant therapy is effective for younger
women in 21 gene receptor score because it helped to restore the
oocytes and prevent pre menopause
• Limitation : lack of data on the chemotherapy-induced
menopause Figure : breast cancer
Source : (Siegel, Miller
& Jemal, 2017).

ARTICLE 2: AN OVERVIEW OF PREGNANCY AND FERTILITY ISSUES IN
BREAST CANCER PATIENTS.
• Aim: The purpose of the paper is to evaluate
the effectiveness of adjuvants therapy in
cancer survival patient (Dabrosin, 2015)
• Method : systematic review of 30 journals for
exploring the effectiveness.
• Result and conclusion : using adjuvant
therapy restored the oocytes through
suppression and prevent early menopause.
• Limitation: relied on the literature of the 30
paper
Figure : breast
cancer and
preagnancy
Source : (Siegel,
Miller & Jemal,
2017)

ARTICLE 3: PATTERNS OF FERTILITY PRESERVATION AND PREGNANCY
OUTCOME AFTER BREAST CANCER AT A LARGE COMPREHENSIVE
CANCER CENTER
• Aim: To evaluate the long term outcome of adjuvant
therapy in the survival of the breast cancer efficiency of
being pregnant (Dieci et al., 2018).
• Method : conducted cohort study within 2004- 2006 and
2014-2016.
• Result and conclusion : fertility issue decreased over the
time because of the therapy
• Limitation: Insufficient data of formal recommendation for
correct timing of the pregnancy.
Figure : pregnancy
in breast cancer
Source: (Dieci et
al., 2018).

ARTICLE 4: TEMPORARY OVARIAN SUPPRESSION DURING
CHEMOTHERAPY TO PRESERVE OVARIAN FUNCTION AND FERTILITY IN
BREAST CANCER PATIENTS: A GRADE APPROACH FOR EVIDENCE
EVALUATION AND RECOMMENDATIONS BY THE ITALIAN ASSOCIATION
OF MEDICAL ONCOLOGY
• Aim : To evaluate the protective role of luteinizing
hormone-releasing hormone analogs during
chemotherapy for temporary repression (Lambertini et
al., 2018).
• Method: The systematic review of the 11 different paper
to understand the result.
• Result and conclusion: Luteinizing hormone-releasing
hormone analogs have a protective effect on
temporality fertility suppression but also exhibit the
toxicity related to the analog.
• Limitation: The study limited to the secondary data. Figure: pregnancy in
breast cancer
Source: (Lambertini et
al., 2018).

• All the journals highlighted the effectiveness of the adjuvant therapy for
restoring the fertility and preventing early menopause.
• However, for the first paper, collection of data on the chemotherapy-
induced menopause and for the third paper , data collection for the formal
recommendation of correct timing of pregnancy. For second and fourth
paper, the recommendation would a collection of primary data.

REFERENCES:
Dabrosin, C. (2015) . An overview of pregnancy and fertility issues in breast cancer patients. Annals of medicine,
47(8), 673-678. http://dx.doi.org/10.3109/07853890.2015.1096953
Dieci, M. V., Ghiotto, C., Barbieri, C., Griguolo, G., Saccardi, C., Gangemi, M., ... & Tasca, G. (2018). Patterns of Fertility
Preservation and Pregnancy Outcome After Breast Cancer at a Large Comprehensive Cancer Center. Journal of
Women's Health. doi: 10.1089/jwh.2018.6986
Lambertini, M., Cinquini, M., Moschetti, I., Peccatori, F. A., Anserini, P., Menada, M. V., ... & Del Mastro, L. (2017).
Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer
patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical
Oncology. European Journal of Cancer, 71, 25-33.
Siegel, R. L., Miller, K. D., & Jemal, A. (2017). Cancer statistics, 2017. CA: a cancer journal for clinicians, 67(1), 7-30.
Sparano, J. A., Gray, R. J., Makower, D. F., Pritchard, K. I., Albain, K. S., Hayes, D. F., ... & Lively, T. (2018). Adjuvant
chemotherapy guided by a 21-gene expression assay in breast cancer. New England Journal of Medicine.doi :
10.1056/NEJMoa1804710

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