年轻乳腺癌患者生育能力保护的研究进展

doi:10.3877/cma.j.issn.1674-0785.2021.02.007

目前，我国癌症负担正在逐年增加，乳腺癌位于我国女性恶性肿瘤发病之首。我国新发病例占全球所有新诊断乳腺癌病例的12.2％，死亡病例占全球乳腺癌死亡病例的9.6％。自2015年12月27日全国人大常委会通过了人口与计划生育法修正案，国家开放二胎政策的正式实施，更使得越来越多的家庭有了生育的需求。为了更深入地探讨年轻乳腺癌患者的生存与生育这一看似矛盾的问题，本文回顾了国内外的相关研究，这些文献显示乳腺癌病史的妇女怀孕是安全的，与未妊娠组相比没有观察到整体生存时间的下降，同时应用生育功能保护手段特别是应用促性腺激素释放激素激动剂，以降低更年期的早期风险及改善生育前景是安全可行的。因此作为临床医师我们有责任为有生育要求的乳腺癌康复者提供帮助并为未来受孕提供尽可能的机会。

关键词: 年轻乳腺癌, 卵巢功能, 促性腺激素释放激素激动剂

China's cancer burden is increasing year by year, and breast cancer has the highest incidence among all female malignancies in Chinese women. New cases in China account for 12.2% of all newly diagnosed breast cancer cases worldwide, and deaths account for 9.6% of global breast cancer deaths. Since the National People's Congress Standing Committee voted to pass the amendments to the Population and Family Planning Law on December 27, 2015, the universal two-child policy has made more and more families have childbearing needs. In order to better balance the contradictory problem of the survival and fertility of young breast cancer patients, this article reviews the relevant research at home and abroad. Those studies unanimously observed that women with a history of breast cancer are safe in pregnancy. No reduction in overall survival was observed compared with the non-pregnant group. At the same time, it is safe and feasible to apply fertility protection measures, especially the application of gonadotropin-releasing hormone agonists, to reduce the early risk of menopause and improve fertility prospects. Therefore, clinicians should correctly provide help for breast cancer survivors who have fertility requirements and provide as many opportunities as possible for future pregnancy.

Key words: Breast cancer in young woman, Ovarian function, Gonadotropin-releasing hormone agonist

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