Searching for metastases in ovarian tissue before autotransplantation: a tailor-made approach

Hoekman, Ellen J.; Smit, Vincent T.H.B.M.; Fleming, Timothy P.; Louwe, L. A.; Fleuren, Gert Jan; Hilders, Carina G. J. M.

doi:10.1016/j.fertnstert.2014.11.001

Cited by 27 publications

(24 citation statements)

References 45 publications

(61 reference statements)

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“…In patients undergoing ovarian tissue cryopreservation an oophorectomy is performed soon after cancer diagnosis. In these patients, disseminated tumor cells may not yet have outgrown into overt metastases and may appear as micrometastases in the ovarian tissues [23, 26, 27]. The chance that tumor cells will then be overlooked is presumably greater.…”

Section: Discussionmentioning

confidence: 99%

Morphological and phenotypical features of ovarian metastases in breast cancer patients

et al. 2017

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BackgroundAutotransplantation of frozen-thawed ovarian tissue is a method to preserve ovarian function and fertility in patients undergoing gonadotoxic therapy. In oncology patients, the safety cannot yet be guaranteed, since current tumor detection methods can only exclude the presence of malignant cells in ovarian fragments that are not transplanted. We determined the need for a novel detection method by studying the distribution of tumor cells in ovaries from patients with breast cancer. Furthermore, we examined which cell-surface proteins are suitable as a target for non-invasive tumor-specific imaging of ovarian metastases from invasive breast cancer.MethodsUsing the nationwide database of the Dutch Pathology Registry (PALGA), we identified a cohort of 46 women with primary invasive breast cancer and ovarian metastases. The localization and morphology of ovarian metastases were determined on hematoxylin-and-eosin-stained sections. The following cell-surface markers were immunohistochemically analyzed: E-cadherin, epithelial membrane antigen (EMA), human epidermal growth receptor type 2 (Her2/neu), carcinoembryonic antigen (CEA), αvβ6 integrin and epithelial cell adhesion molecule (EpCAM).ResultsThe majority of ovarian metastases (71%) consisted of a solitary metastasis or multiple distinct nodules separated by uninvolved ovarian tissue, suggesting that ovarian metastases might be overlooked by the current detection approach. Combining the targets E-cadherin, EMA and Her2/neu resulted in nearly 100% detection of ductal ovarian metastases, whereas the combination of EMA, Her2/neu and EpCAM was most suitable to detect lobular ovarian metastases.ConclusionsExamination of the actual ovarian transplants is recommended. A combination of targets is most appropriate to detect ovarian metastases by tumor-specific imaging.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3191-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Morphological and phenotypical features of ovarian metastases in breast cancer patients

et al. 2017

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“…Using PCR technique, mammaglobin 1 (MGB1), gross cystic disease fluid protein 15, and small breast epithelial mucin showed the highest predictive values in the detection of micro-metastases in ovarian tissue of breast cancer [60][61][62][63] . Hoekman, et al detected positive MGB1 expression in ovarian tissue in one out of three patients with breast cancer and sentinel lymph node involvement 61 . Results are reassuring overall, but further studies are needed to confirm the clinical relevance of the detection of these markers to adequately counsel patients.…”

Section: Tamoxifen-associated Ovarian Hyperstimulationmentioning

confidence: 99%

Viable Options for Fertility Preservation in Breast Cancer Patients: A Focus on Latin America

Lambertini

Goldrat

Barragán-Carrillo

et al. 2017

RIC

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Thanks to the improved survival outcomes observed in recent years, a growing attention has been given to the quality of life issues faced by young women with breast cancer such as fertility preservation and concerns related to future pregnancies.However, several challenges remain for young women with breast cancer considering undergoing fertility preservation strategies.Further specific issues on this regard should be taken into account in Latin America, where patients and physicians face particular barriers that hinder the routine adoption of this practice. Hence, further efforts are needed to overcome these deficiencies and improve the correct referral of breast cancer patients to fertility preservation strategies.The aim of the present review is to focus on the risk of anticancer treatment-related premature ovarian failure and infertility in young breast cancer patients, to summarize the current knowledge on the available options for fertility preservation, and to discuss the safety issues of pregnancy in breast cancer survivors. Furthermore, this review aims to highlight the specific clinical challenges in this field encountered by healthcare providers and young breast cancer patients from Latin American countries. (REV INVES CLIN. 2017;69:103-13)

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“…According to analyses of ovarian necropsies, the risk of ovarian involvement in young breast cancer patients reached 19.4% (11) but was considered as low to moderate at the time of diagnosis (12). However, only a few studies addressed this issue by investigating the presence of micrometastases in ovarian cortex of women with breast cancer undergoing the cryopreservation procedure (13)(14)(15)(16)(17)(18). Histology and immunohistochemistry tests targeting cytokeratins and/or breast markers such as mammaglobin 1 (MGB-1) and gross cystic disease fluid protein-15 (GCDFP-15) did not reveal malignant cells in the ovarian cortex of breast cancer patients undergoing the cryopreservation procedure.…”

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confidence: 99%

“…This strategy has been successfully used for the detection of leukemia or lymphoma cells in the ovarian cortex (4,6,7) and to monitor the number of circulating tumor cells (CTCs) in the peripheral blood of breast cancer patients (19,20). Recently, two studies evaluated the presence of breast cancer micrometastases in cryopreserved ovarian tissue by molecular tools (17,18). Hoekman et al (18) did not observe any overexpression of MGB-1 in the ovarian cortex stored for fertility preservation in breast cancer patients.…”

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confidence: 99%

“…Recently, two studies evaluated the presence of breast cancer micrometastases in cryopreserved ovarian tissue by molecular tools (17,18). Hoekman et al (18) did not observe any overexpression of MGB-1 in the ovarian cortex stored for fertility preservation in breast cancer patients. In the second report, the authors showed that ovarian tissue from advanced breast cancer patients may carry cells expressing mammaglobin 2 (MGB-2) but did not confirm tumoral ovarian involvement after long-term xenotransplantation (17).…”

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Evaluation of quantitative polymerase chain reaction markers for the detection of breast cancer cells in ovarian tissue stored for fertility preservation

Bockstaele

Boulenouar

Steen

et al. 2015

Fertility and Sterility

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Searching for metastases in ovarian tissue before autotransplantation: a tailor-made approach

Cited by 27 publications

References 45 publications

Morphological and phenotypical features of ovarian metastases in breast cancer patients

Morphological and phenotypical features of ovarian metastases in breast cancer patients

Viable Options for Fertility Preservation in Breast Cancer Patients: A Focus on Latin America

Evaluation of quantitative polymerase chain reaction markers for the detection of breast cancer cells in ovarian tissue stored for fertility preservation

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