Abstract P4-01-09: REAL-LIFE OUTCOMES OF A 10-YEAR ONCOFERTILITY PROGRAM IN EARLY BREAST CANCER PATIENTS

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Abstract Introduction: Fertility preservation (FP) is a critical aspect of care for young breast cancer (BC) patients. Guidelines on FP from cancer societies recommend that patients in their reproductive years should receive fertility counselling and, if interested, should be timely referred to a FP specialist. There is, however, limited information on real-life follow-up of BC patients who underwent FP. We aimed to assess the outcomes of an Oncofertility program in young women with early breast cancer (EBC) proposed for curative treatment with chemotherapy (CT). Methods: Retrospective analysis of EBC patients under 40 years proposed for FP before curative CT in an EBC clinic of a tertiary cancer center from January 2012 to December 2021. FP procedures were carried out in 3 different fertility units. Collected data covered patient demographics, BC characteristics, genetic risk, treatment, survival outcomes and FP methods and complications, number of oocytes retrieved, oocyte utilization, pregnancies, live births, ongoing pregnancies, miscarriages and elective terminations. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan Meyer method. Results: In the study period 88 women were referred to FP and 70 (80%) accepted to proceed with FP after specialist appointment. Median follow-up time was 6.9 years. Median age was 32 years (interquartile range [IQR] 29-36). Before diagnosis 38% of women had been pregnant and 30% had children. Patient BC was staged as II in 55% and III in 24% of cases and 48% had node positive disease. Hormone receptor expression was found in 77% of tumors, HER2 in 25% and 16% were “triple negative”. Genetic testing was done in 93% of patients and germline pathogenic variants were identified in 16%, including BRCA in 13%. Neoadjuvant CT was performed in 67% of patients and adjuvant CT in 32%. CT protocol included anthracyclines in 87% of treatments. Median time from FP specialist referral to CT start was 3.7 weeks (IQR 3.0-5.5). The methods used for FP were oocyte (91%) (median number of oocytes retrieved: 10 [IQR 6-16.3]), both oocyte and embryo (2%) and ovarian tissue (4%) cryopreservation. There were complications in 2 patients (3%): ovarian hyperstimulation syndrome and hemorrhagic corpus luteum. Adjuvant endocrine therapy (ET) was administered to 76% of patients. Interruption to attempt pregnancy happened in 40% with a median ET exposure time of 4 years (IQR 2.8-5.4). After FP, 38 pregnancies occurred in 24 patients (34%). We observed 18 live births (47%), 11 miscarriages (29%), 4 elective terminations (11%) and 5 pregnancies are ongoing (13%). Artificial reproductive technologies were used in 29% of pregnancies, all with oocytes retrieved pre-CT. Median time to pregnancy was 4.3 years (IQR 2.9-6.5). Oocyte utilization rate was 19% (13 patients). Among oocyte users 11 pregnancies (29% of all pregnancies) occurred in 10 women (77%). We observed 6 live births (55%), 4 miscarriages (36%) and 1 pregnancy is ongoing (10%). Overall, FP was performed in 7 patients to achieve one pregnancy via cryopreserved material and in 12 patients to achieve a live birth. DFS and OS at 5 years was 82.1% and 92.0%, respectively. Conclusion: In our cohort FP outcomes were encouraging. FP appeared to be effective and complications were rare and manageable, with no worrisome trends regarding DFS or OS. Clinician awareness and ongoing research in FP will provide more opportunities for BC patients to achieve their reproductive goals. Citation Format: Bernardo Pereira, Duarte Machado, Hugo Nunes, Teresa Santos, Alexandra Santos, Teresinha Simões, Ana Marujo, Iris Bravo, Beatriz Mira, Emanuel Gouveia, Patricia Pereira, Catarina Cardoso, Susana Esteves, Catarina Relvas, Madalena Machado, Margarida Pereira, António Moreira, Fátima Vaz, Margarida Brito. REAL-LIFE OUTCOMES OF A 10-YEAR ONCOFERTILITY PROGRAM IN EARLY BREAST CANCER PATIENTS [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-01-09.

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