Prognostic Impact of Pregnancy After Breast Cancer According to Estrogen Receptor Status: A Multicenter Retrospective Study

Azim, Hatem A.; Kroman, Niels; Paesmans, Marianne; Gelber, Shari; Rotmensz, Nicole; Ameye, Lieveke; Mattos-Arruda, Leticia De; Pistilli, Barbara; Pinto, Álvaro; Jensen, Maj Britt; Córdoba, Octavi; Azambuja, Evandro de; Goldhirsch, Aron; Piccart, Martine; Peccatori, Fedro Alessandro

doi:10.1200/jco.2012.44.2285

Cited by 206 publications

(166 citation statements)

References 25 publications

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“…[124][125][126][127][128][129] In particular, in a recent multicenter, retrospective cohort study in which 333 patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER status, nodal status, adjuvant therapy, age, and year of diagnosis, no difference in DFS was observed between pregnant and non-pregnant patients in the HR+ population at a median follow-up of 5 years following conception. 126 Therefore, pregnancy after breast cancer should not be discouraged, even though definitive data from prospective clinical trials are needed. 127 A prospective global cooperative study, the POSITIVE study has been commenced with the aim of assessing the safety and feasibility of interrupting ET for pregnancy after breast cancer -enrolment in the study should be strongly encouraged among women who desire early pregnancy after diagnosis, as this will likely be the only prospective study on pregnancy after breast cancer.…”

Section: Brca Mutation Carriers (Table 8)mentioning

confidence: 99%

Second international consensus guidelines for breast cancer in young women (BCY2)

et al. 2016

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Section: Brca Mutation Carriers (Table 8)mentioning

confidence: 99%

Second international consensus guidelines for breast cancer in young women (BCY2)

et al. 2016

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“…HER-2 status was unknown in approximately 80% of all cases. In both the ER positive group and in the ER negative group no difference of disease free survival was detected after pregnancy compared to controls (11). In addition, in the ER negative group a significant increase in overall survival was detected whereas in the ER positive group no difference in survival between index cases and controls was revealed (11).…”

Section: Pregnancy After Breast Cancer Treatmentmentioning

confidence: 80%

“…In both the ER positive group and in the ER negative group no difference of disease free survival was detected after pregnancy compared to controls (11). In addition, in the ER negative group a significant increase in overall survival was detected whereas in the ER positive group no difference in survival between index cases and controls was revealed (11). Regarding the timing of pregnancy after breast cancer diagnosis a surprisingly increase in the disease free survival was detected in patients who became pregnant within two years of diagnosis whereas no difference was found in the group that became pregnant more than two years after breast cancer diagnosis (11).…”

Section: Pregnancy After Breast Cancer Treatmentmentioning

confidence: 93%

“…Another issue is whether there is a difference in recurrence rate depending on hormone dependent breast cancer compared to other types of the disease. A recent multicenter retrospective study comprising of 333 pregnancies after breast cancer and 874 matched non-pregnant controls was powered to detect possible differences regarding to tumor type (11). In addition to estrogen receptor (ER) status the patients were matched for nodal status, adjuvant therapy, age, and year of diagnosis (11).…”

Section: Pregnancy After Breast Cancer Treatmentmentioning

confidence: 99%

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An overview of pregnancy and fertility issues in breast cancer patients

Dabrosin

2015

Annals of Medicine

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Breast cancer is one of the most common malignancies of women in the reproductive years. In the Western world there is a trend towards delaying pregnancy to later in life and in combination with an increased incidence of breast cancer an increased number of women are diagnosed with breast cancer before they have completed their reproductive plans. In addition, breast cancer during pregnancy may affect an increased number of women as the childbearing years are delayed. The survival rate after breast cancer has improved during the last decades and many young breast cancer survivors will consider a pregnancy subsequent to the completion of adjuvant breast cancer therapy. Traditionally, many women are advised against a pregnancy due to a fear of increased risk of recurrence, especially women with estrogen receptor positive breast cancer. Due to feasibility issues, evidence from large prospective randomized trials are missing regarding the safety of pregnancy after breast cancer. Today guidelines are based on cohort studies and population-based registry evidence with its limitations. Overall, data suggest that pregnancy after breast cancer therapy is safe and the current evidence is summarized in this overview.Keywords: breast cancer, mammary cancer, pregnancy, estrogen receptor, fertility 3 Key messages: Despite the lack of high-level evidence all retrospective data report no unfavorable effect on breast cancer outcome of a subsequent pregnancy after adjuvant breast cancer therapy. There are no reasons for proscription in principle against pregnancy for women after breast cancer therapy. The risk of premature menopause, infertility, and the suitability of fertility preservation approaches need to be discussed in a multidisciplinary setting with all eligible women before start of cytotoxic therapies. Women with breast cancer during pregnancy should be given appropriate systemic treatment as closely as possible to general guidelines.4

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“…In accordance with an ongoing rise in its incidence among young women [1,2], and with the current social trend to delay motherhood until later in life, we nowadays witness an increasing number of patients who have not completed childbearing when cancer is diagnosed and who are likely to desire pregnancy once cure has been confirmed. Although previously thought to be contraindicated purely on theoretical basis, pregnancy following successfully cured breast cancer is currently not considered unsafe, including in patients with a history of hormone receptorpositive disease [3].…”

Section: Introductionmentioning

confidence: 99%

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

Shapira

Raanani

Meirow

2015

J Assist Reprod Genet

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Background Potential risks on future fertility have become a dominant issue in consultation and management of newly diagnosed young cancer patients. Several fertility preservation strategies are currently available. Of those, ovarian stimulation followed by IVF and embryo cryopreservation is the most established one and is especially applicable in reproductive aged breast cancer patients. Aim The aim of this study is to provide a comprehensive review on ovarian stimulation and IVF for fertility preservation in newly diagnosed breast cancer patients. Methods Review of relevant literature is available through PubMed and Google scholar. Results The use of IVF for fertility preservation in breast cancer patients raises dilemmas regarding efficacy and safety of controlled ovarian stimulation. Among these are the suggested role of malignancy and BRCA mutation in reducing ovarian response to stimulation, strategies designated to protect against hyper-estrogenic state associated with stimulation (co-treatment with tamoxifen or letrozole), and possible adjustments to accommodate oncologic-related time constraints. Conclusion Ovarian stimulation followed by IVF forms an important fertility preservation strategy for newly diagnosed young breast cancer patients, though live born rates following thawed embryo transfer in these patients are still lacking. Recent advances in controlled ovarian stimulation protocols provide practical options for some of the challenges that breast cancer patients present.

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Prognostic Impact of Pregnancy After Breast Cancer According to Estrogen Receptor Status: A Multicenter Retrospective Study

Abstract: Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.

Cited by 206 publications

References 25 publications

Second international consensus guidelines for breast cancer in young women (BCY2)

Second international consensus guidelines for breast cancer in young women (BCY2)

An overview of pregnancy and fertility issues in breast cancer patients

IVF for fertility preservation in breast cancer patients—efficacy and safety issues

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