In vitro fertilization impact on the risk of breast cancer.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Archive of clinical cases Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.22551/2024.44.1103.10292
Ana-Maria Mihai, Laura Maria Ianculescu, Dragoş Creţoiu, Nicolae Suciu
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Abstract

Breast cancer, with its increasing incidence and high mortality rates, remains a major global health challenge, significantly impacting individuals, families, and societies. Understanding the multifactorial risk factors contributing to its development is crucial for effective prevention and management. Hormonal factors play a significant role in breast cancer development. Given that ovarian steroid hormones influence breast function, any gonadotropin hormone or fertility drug that stimulates ovulation may also impact breast tissue. Contrary to the findings of studies with smaller sample sizes, concerns have emerged regarding the potential increased risk of breast cancer following in vitro fertilization (IVF) treatments. This article explores the potential risk of breast cancer associated with hormonal cycles during IVF, supported by a literature review and a case study conducted in a tertiary hospital in Bucharest, Romania. The case involves a 38-year-old patient with a history of hormonally treated endometriosis and five IVF cycles, who presented for mammographic and ultrasound screening. The screening revealed multicentric and multifocal BIRADS-5 lesions, with histopathological and immunohistochemical analysis confirming invasive breast carcinoma of no special type with ductal carcinoma in situ, HER2 positive (3+), estrogen receptor and progesterone receptor negative, and a Ki-67 proliferation index of 50%.

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体外受精对乳腺癌风险的影响。
乳腺癌发病率不断上升,死亡率居高不下,仍然是全球健康面临的一大挑战,对个人、家庭和社会都有重大影响。了解导致乳腺癌发生的多因素风险因素对于有效预防和管理乳腺癌至关重要。荷尔蒙因素在乳腺癌的发病中起着重要作用。鉴于卵巢类固醇激素会影响乳房功能,任何刺激排卵的促性腺激素激素或生育药物也可能影响乳腺组织。与样本量较小的研究结果相反,人们对体外受精(IVF)治疗后乳腺癌的潜在风险增加表示担忧。本文通过文献综述和在罗马尼亚布加勒斯特一家三甲医院进行的病例研究,探讨了体外受精过程中与荷尔蒙周期相关的乳腺癌潜在风险。该病例涉及一名 38 岁的患者,她曾接受过激素治疗的子宫内膜异位症和五个试管婴儿周期,并接受了乳房 X 线照相术和超声波筛查。筛查发现了多中心、多灶性 BIRADS-5 病变,组织病理学和免疫组化分析证实为无特殊类型的浸润性乳腺癌,伴有导管原位癌,HER2 阳性(3+),雌激素受体和孕激素受体阴性,Ki-67 增殖指数为 50%。
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