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Fertility Preservation and Assisted Reproductive Technologies Do Not Impact Cancer Recurrence Rates in HR+ Breast Cancer Patients: A Look at the POSITIVE Trial

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Mason Walker
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Fertility Preservation and Assisted Reproductive Technologies Do Not Impact Cancer Recurrence Rates in HR+ Breast Cancer Patients: A Look at the POSITIVE Trial

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The POSITIVE Trial Outcomes

Presented at the San Antonio Breast Cancer Symposium, the POSITIVE trial brings encouraging news for hormone receptor (HR)-positive breast cancer patients wishing to bear children. The study revealed that fertility preservation and/or assisted reproductive technologies (ART) do not have a negative impact on the three-year cancer recurrence rates among patients who paused endocrine therapy to become pregnant. This finding is a significant milestone in the fertility counseling of young breast cancer patients.

Fertility Preservation and the Risk of Recurrence

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One of the crucial findings of the POSITIVE trial (NCT02308085) is that individuals with HR+ breast cancer could pause endocrine therapy for up to two years to become pregnant, without increasing the risk of recurrence. This discovery counters previous concerns that pausing endocrine therapy might heighten the risk of cancer recurrence. Moreover, the use of fertility preservation and ART did not impact the three-year cancer recurrence rates for these patients.

The Role of Age and Cryopreserved Embryo Transfer

The study also found that younger age and cryopreserved embryo transfer were the factors most associated with higher chances of pregnancy. Interestingly, ovarian stimulation for cryopreservation, which precedes cryopreserved embryo transfer, was not associated with worse disease outcomes. This suggests that these fertility preservation methods can be safely used without causing adverse effects on the course of the disease.

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Impact on Menstrual Cycles and Time to Pregnancy

Most patients who had amenorrhea at trial entry saw their menstrual cycles return within six months of pausing endocrine therapy. This is a positive indicator for those patients who wish to conceive post-treatment. Furthermore, the type of adjuvant endocrine therapy the patient had received had no impact on the time to pregnancy. This implies that patients can choose the type of adjuvant endocrine therapy best suited to their needs without worrying about it affecting their fertility timeline.

A Milestone in Fertility Counselling for Breast Cancer Patients

The findings of the POSITIVE trial provide valuable insights for fertility counseling of young breast cancer patients. It gives them hope that they can safely pause endocrine therapy, use fertility preservation methods or ART, and conceive without adversely affecting their disease outcomes. In a world where cancer often seems like a sentence, these findings bring a ray of hope for patients who dream of motherhood.

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