Tumori Journal Abstract Book - October 2020 - 117

E - Breast Cancer	

117

the last years, several studies investigated the role of adjuvant ET (AET) extension beyond the first 5 years, globally
demonstrating a reduction in the rate of disease relapse,
particularly in high-risk patients. However, the vast majority of trials exploring AIs extension included postmenopausal women only. Therefore, compelling evidence
supporting the extension of AET with AIs in premenopausal patients is currently missing. The aim of the present
study was to reach an Italian expert consensus on the
extended AET in premenopausal patients.
Material and methods: Firstly, a Steering Committee
defined relevant statements on the topic. Subsequently, a
panel of 8 Italian oncologists with expertise in breast cancer participated in this Delphi consensus study in January
2020. According to the Delphi method, experts voted
anonymously each statement, expressing their level of
agreement using a five point Likert scale. For each statement, the consensus was reached if either the sum of negative or positive answers exceeded 66%. Currently, the
study has been extended to additional 12 Italian oncologists, using a web-based format, due to the COVID-19
pandemic. Altogether, the 20 participants represent oncological institutions distributed over the country.
Results: A total of 44 statements were defined and voted
to gain consensus. The statements concerned clinical,
pathological and genomic factors that could be used to
assess the utility, the type (AIs vs. tamoxifen) and the duration (2-2.5 vs. 5 years) of extended AET in premenopausal
patients. The consensus reached on each statement will be
presented during the congress.
Conclusions: Intermediate/high-risk premenopausal EBC
patients are likely to benefit from extended AET, although
studies specifically designed in premenopausal setting are
still missing. In the lack of direct evidence, this methodologically sound expert consensus may guide practicing
oncologists in the choice of the best treatment and duration
based on clinical, pathological and genomic information.

therapy efficacy. Temporary ovarian suppression with
GnRH analogue may preserve ovarian function even if
clinical data are conflict.
Patients and methods: From 1/2013 to 12/2017 we have
selected young W ⩽ 35 years with triple negative and
HER2 positive hormonal receptors negative EBC, who
were anxious about preserving fertility after surgery, to
receive leuprolide (L) 3.75 mg every 28 days (D) starting
between 7 and 14 D before CT while the last injection was
administered between 7 D before and 21 D after the last
CT. During trastuzumab (T) monotherapy was not administered leuprolide.
Results: 21 W, median age 33 years,interested to go physiological pregnant after CT accepted to participate at the
study, 12 were HER2 positive and 9 triple negative, all
received CT and 9 CT+T. Although it is hard to give an
exact length of time to wait before P after CT, we recommended at least. End points were recovery of menstruation
within 6 months (M) and rate of successful conception
within 3/2020. All pts recovered menses within 6 M (4-6 M)
after the last dose of L. After the end of CT, 3 pts in trastuzumab refused to continue the study and 1 pt resulted with
BRCA mutation was excluded. 17 pts completed the followup. At the time analysis 11 pts (65%) have managed to
achieve P. 13 P among 11 pts,11 were natural birth 2 caesarean delivery. All newborns were healthy. Moreover 2 pts
used assisted fertility. Median time to achieving P from the
EBC diagnosis was 36 M. 1 pt had local relapse after P.
Conclusions: Fertility preservation is an important issue
for young W. CT increases the risk of premature menopause and GnRH analogues preserve ovarian function
through some ways. To date the options to avoid sterility
CT induced include embryo cryopreservation and oocyte
or ovarian cryopreservation but these procedures are
costly, complex and have a significant failure rate. Our
results as well as other experiences support the efficacy of
GnRH in the preservation of ovarian function and fertility
moreover the treatment is simple, has low cost and does
not require delaying the CT.

E34
Fertility and pregnancies in
young women with early breast
cancer
1

2

3

Bottari M. , Maisano R. , Foti G.
1

U.O. Ginecolgia e Ostetricia, A.O.U. G. Martino Policlinico Messina, Messina;
U.O. Oncologia Medica G.O.M., Reggio Calabria; 3U.O. Ginecologia e
Ostetricia A.O.U. G. Martino Policlinico Messina, Messina
2

E35
Estradiol monitoring in
premenopausal women treated
with leuprolide plus exemestane
as adjuvant therapy
Foti G.1, MaisanoU R.2, Bottari M.3
1

Background: Chemotherapy (CT) in younger women (W)
with early breast cancer (EBC) has improve outcome with
some long-term toxic effects among which premature
menopause and infertility. In developed countries the age
of first pregnancy (P) is often delaying and median age at
first live birth is 30 years. In younger W with EBC eager to
have children is needed to preserve fertility without reduce

U.O. Ginecologia e Ostetricia, A.O.U. G. Martino Messina, Messina; 2U.O.
Oncologia Medica G.O.M., Reggio Calabria; 3U.O. Ginecologia e Ostetricia
A.O.U. G. Martino Policlinico Messina, Messina

Background: For many years, tamoxifen (T) has been the
standard adjuvantendocrine treatment option for premenopausal women with hormone receptor-positive tumors. In
recent years, evidence on the role of ovarian function



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

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