Pregnancy After Breast Cancer Appears to Be Safe

A study of young women found that pregnancy after a diagnosis of estrogen receptor-positive breast cancer does not appear to increase the risk of cancer recurrence. These results were presented at the eighth European Breast Cancer Conference.?????

Breast cancer is the most common type of cancer among women of childbearing age. For women who develop breast cancer before completing their families, many questions arise about fertility preservation and the safety of a subsequent pregnancy. In the case of estrogen receptor-positive breast cancer, there has been some uncertainty about whether the hormonal changes of pregnancy could increase the risk of cancer recurrence.??

To explore whether pregnancy affects risk of breast cancer recurrence, researchers from several countries conducted a study among 333 women who had become pregnant after a diagnosis of breast cancer, and 874 similar women who did not become pregnant. ?

The women aged in range from 21 to 48 (average age was 34).??

Recurrence risk was similar in the women who did and did not become pregnant. This was true for women with estrogen receptor-positive breast cancer and for women with estrogen receptor-negative breast cancer. ?In the subset of women who became pregnant soon after their breast cancer diagnosis (within two years), risk of recurrence was actually somewhat lower than in the women who did not become pregnant. The researchers recommend caution in interpreting this result, noting “pregnancy within two years of diagnosis should be regarded as safe, and not as protective.”?Miscarriage, abortion, and breastfeeding did not appear to affect breast cancer outcome.??

Although this study does not provide definitive proof of the safety of pregnancy after breast cancer, these results should be reassuring to women who wish to become pregnant after a breast cancer diagnosis.?????

Because some types of cancer treatment can affect a woman’s fertility, women who are interested in becoming pregnant should discuss the issue of fertility preservation with their physician before cancer treatment begins.????

Reference: Azim Jr H, Kroman N, Ameye L et al. Pregnancy following estrogen receptor-positive breast cancer is safe – results from a large multi-center case-control study. Paper presented at: eighth European Breast Cancer Conference (EBCC8); March 21-24, 2012;? Vienna, Austria. Abstract 21. ?

Posted March 30, 2012

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Pregnancy Doesn’t Appear to Worsen Breast Cancer Outcomes

According to the results of a study conducted at the M. D. Anderson Cancer Center, women who are diagnosed with breast cancer and treated with chemotherapy while pregnant have a better disease-free survival (survival without a cancer recurrence or a new cancer) than women who are not pregnant at the time of diagnosis. Overall survival was similar in the two groups of patients. These results were presented at the 2010 Breast Cancer Symposium.

Previous reports have suggested that being pregnant at the time of diagnosis worsens breast cancer outcomes. This may have been due to older approaches to cancer treatment, in which pregnant women received less effective cancer treatment than non-pregnant women or delayed cancer treatment until after the birth of the baby.

A recent study compared breast cancer outcomes between pregnant and non-pregnant women who were treated with 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC).[1] In pregnant women, treatment with FAC was administered after the first trimester of pregnancy. When additional therapies—such as hormonal therapy—were warranted, these were started after the woman gave birth. Each of the 54 pregnant breast cancer patients treated was matched with two non-pregnant patients based on age and stage of cancer.

Overall survival between pregnant and non-pregnant women was similar. In fact, pregnant women appeared to have a slightly better overall five-year survival (77%) than their non-pregnant counterparts (72%). ??????????? This difference, however, was not statistically significant and may be the result of chance alone.

For five-year disease-free survival, results were significantly better for pregnant women: 74% versus 56% for non-pregnant women.

These results suggest that with current approaches to treatment, pregnancy does not worsen breast cancer outcomes. In a prepared statement, one of the authors of the study stated “Now, when we are counseling breast cancer patients who are pregnant, we can say that they should have every expectation that they will do as well as our non-pregnant patients, and that they should start their treatment in the second or third trimester without delay.”[2]

References:

[1] Litton JK, Warneke CL, Hahn K, et al. Case-control analysis of patients (pts) treated with chemotherapy during pregnancy for breast cancer (BC). Presented at the Breast Cancer Symposium, Washington, DC, October 1-3, 2010. Abstract 105.

[2] MD Anderson News Release. UT MD Anderson Study Finds Women Treated for Breast Cancer While Pregnant Have Improved Survival. 09/29/10.

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