年轻乳腺癌患者生育力保存现状与临床应对策略

尽管抗癌治疗可以提高年轻乳腺癌患者长期生存率,但也可能导致生育力降低。随着我国乳腺癌发病年轻化,年轻乳腺癌患者的生育需求获得更多关注,适用于癌症患者的生育力保存技术不断发展。但目前我国年轻乳腺癌患者生育力保存的实施仍然存在很多问题:患者和乳腺外科医师对生育力保存技术认识不足,且态度保守;治疗过程中缺少生殖科专家的意见;对保存生育力患者的长期随访和信息管理不完善等。为改善上述现状,首先应提高医师对生育力保存的了解,包括相关技术的进展和适用人群、介入时机,以及癌症治疗结束后何时妊娠、如何妊娠等;其次要加强对患者进行生育力保存相关的宣教,特别是癌症治疗期间科学避孕方法和意外怀孕的处理;最后,医院和相关单位应完善和规范乳腺癌多学科团队诊疗,加强年轻乳腺癌患者的综合管理,从而为年轻乳腺癌患者提供更科学的肿瘤治疗方案和更多的生育机会。

Status and clinical response of fertility preservation in young patients with breast cancer

Cancer treatments may improve the long-term survival rate of young patients with breast cancer,but also lead to a decrease in fertility.With the younger incidence of breast cancer in China,the fertility needs of this group have received more attention,and fertility preservation technology suitable for cancer patients is developing continuously.However,there are still many problems in the implementation of fertility preservation for young breast cancer patients in China.Patients and breast surgeons have insufficient understanding and conservative attitudes towards fertility preservation technology.And there is a lack of reproductive experts in the treatment process.What′s more,the long-term follow-up and information management of patients undergoing fertility preservation are defective.In response to the above,this paper discusses how to deal with patients with potential reproductive needs in clinical practice from the perspective of breast surgeons.The first is to improve their own understanding of fertility preservation,such as the progress of relevant technologies and applicable population,when to intervene,when and how to get pregnant after cancer treatment.Secondly,education for patients must be strengthened,which should include not only fertility preservation,but also scientific contraceptive methods during cancer treatment and treatment measures for unexpected pregnancy.Finally,hospitals and relevant units should standardize the multidisciplinary team of breast cancer,and strengthen the comprehensive management of young breast cancer patients,thus to provide young breast cancer patients with more scientific cancer treatment programs and more reproductive opportunities.