Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2019; 7(1): 58-68
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.58
Full-term pregnancy in breast cancer survivor with fertility preservation: A case report and review of literature
Marta Garrido-Marín, Pedro Maria Argacha, Luís Fernández, Florencia Molfino, Fina Martínez-Soler, Avelina Tortosa, Pepita Gimenez-Bonafé
Marta Garrido-Marín, Pepita Gimenez-Bonafé, Department of Physiological Sciences, Physiology Unit, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, L’Hospitalet del Llobregat, Barcelona 08907, Spain
Pedro Maria Argacha, Hospital Universitari General de Catalunya, Barcelona 08190, Spain
Luís Fernández, Servicio de Oncología Médica, Consorcio Corporación Sanitaria Parc Taulí, Barcelona, Sabadell 08208, Spain
Florencia Molfino, Instituto de Reproducción Cefer, Barcelona 08017, Spain
Fina Martínez-Soler, Avelina Tortosa, Department of Basic Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, IDIBELL, L’Hospitalet del Llobregat, Barcelona 08907, Spain
Author contributions: Garrido-Marín M was in charge of collecting the data from the different centers involved in the case report and wrote the manuscript; Argacha PM, Fernández L, and Molfino F collected the data from their files and helped with the chronological organization of all the clinical events of the patient; Martínez-Soler F and Tortosa A revised the manuscript; Gimenez-Bonafé P generated the final version of the manuscript, collected and organized the data, and revised the manuscript.
Supported by grants from the Instituto Carlos III, Nos. PI 11/01377 and ISCIII-RETICRD12/0036/0029; Government of Catalonia, No. 2017SGR-1014.
Informed consent statement: The patient authorized the medical team to write up her clinical history and allowed for the data and clinical photographs to be published. Her identity is protected throughout the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist-2016.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Pepita Gimenez-Bonafé, BsC, BSc, MSc, PhD, Senior Research Fellow, Full-time Professor and Scientist, Department of Physiological Sciences, Universitat de Barcelona, Carrer Feixa Llarga, s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain. pgimenez@ub.edu
Telephone: +34-934-039727 Fax: +34-934-024268
Received: July 13, 2018
Peer-review started: July 13, 2018
First decision: October 8, 2018
Revised: November 20, 2018
Accepted: November 30, 2018
Article in press: December 1, 2018
Published online: January 6, 2019
Abstract

A 43-year-old woman with an associated history of gynecological pathology and breast cancer with only one cryopreserved embryo wished to be a mother. Several factors that influenced the success of the pregnancy in this case were analyzed. Favorable factors included: triple positive breast cancer [positive hormone receptors and positive human epidermal growth factor receptor 2], which is more hormosensitive and chemosensitive; absence of metastasis; correct endometrium preparation; and the patient’s optimistic attitude and strict health habits. In contrast, the factors against success were: breast cancer; adjuvant breast cancer therapy gonadotoxicity; the age of the patient (> 40-year-old); endometriosis; ovarian cyst; hydrosalpinx; submucosal fibroids and the respective associated surgery done for the above-mentioned pathology (all resolved prior to the embryo transfer); and a low quantity of ovules (low ovarian reserve) after ovarian stimulation. This is a very special clinical case of a patient with theoretically low pregnancy success probability due to the consecutive accumulation of gynecological and oncological pathologies, who nonetheless became pregnant and delivered a full-term infant and was able to provide adequate breastfeeding.

Keywords: Breast cancer, Fertility preservation, Gonadotoxicity, Pregnancy, In vitro fertilization, Hydrosalpinx, Endometriosis, Case report

Core tip: Considering age, endometriosis, a hyperplastic endometrium, the presence of myomas, amenorrhea, breast cancer, chemo- and radiotherapy and in vitro fertilization with a single cryopreserved embryo, the likelihood of a successful pregnancy was low. This case report details how a 43-year-old woman was able to overcome these negative aspects and become the mother of a healthy baby.