Safety of Pregnancy After Primary Breast Carcinoma in Young Women: A Meta-Analysis to Overcome Bias of Healthy Mother Effect Studies

Valachis, Antonis; Tsali, Lampriani; Pesce, Lorenzo L.; Polyzos, Nikolaos P.; Dimitriadis, C. A.; Tsalis, Konstantinos; Mauri, Davide

doi:10.1097/ogx.0b013e31821285bf

Cited by 71 publications

(42 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After considering the potential for such a bias in the matched controls, ten studies were eligible, and nine contained data appropriate for analysis. Overall survival was statistically higher among patients who became pregnant than among those who did not, showing that pregnancy occurring at least 10 months after a bca diagnosis does not jeopardize prognosis and might even confer a significant survival benefit 60 . The same results were also recently reported in a third meta-analysis studying the safety of pregnancy after surgical treatment for bca.…”

Section: Meta-analysismentioning

confidence: 93%

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

2015

View full text Add to dashboard Cite

show abstract

Section: Meta-analysismentioning

confidence: 93%

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

2015

View full text Add to dashboard Cite

show abstract

“…A meta-analysis designed to correct for the "healthy mother effect" included over 1000 women with pregnancy after breast cancer diagnosis and over 13000 health-matched controls. This study noted improved survival in women who became pregnant after breast cancer treatment as compared to those who did not, hazard ratio 0.51 [95% confidence interval (CI), 0.42-0.62] suggesting that pregnancy at least 10 mo post breast cancer treatment in women < 45 years does not adversely affect prognosis and may in fact significantly improve survival [60] . About 50% of women can lactate after breast cancer therapy, but breast milk volume tends to be reduced [61] .…”

Section: Management Of Vulvovaginal Atrophy In the Breast Cancer Survmentioning

confidence: 96%

“…Estrogen-receptor status does not impact breast cancer recurrence with pregnancy [59] . Initial studies noting improved outcome in women who become pregnant after breast cancer were attributed to better baseline status in women who chose pregnancy, the so-called "healthy mother effect" [60] . A meta-analysis designed to correct for the "healthy mother effect" included over 1000 women with pregnancy after breast cancer diagnosis and over 13000 health-matched controls.…”

Section: Management Of Vulvovaginal Atrophy In the Breast Cancer Survmentioning

confidence: 99%

Caring for the breast cancer survivor’s health and well-being

Casey¹

2014

WJCO

View full text Add to dashboard Cite

The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In this comprehensive review, we critically review and evaluate recent evidence regarding several topics pertinent to and specific for the woman living with a prior history of breast cancer. More specifically, we discuss the most recent recommendations for contraceptive options including long-acting reversible contraception and emergency contraception, fertility and pregnancy considerations during and after breast cancer treatment, management of menopausal vasomotors symptoms and vulvovaginal atrophy which often occurs even in young women during treatment for breast cancer. The need to directly query the patient about these concerns is emphasized. Our focus is on non-systemic hormones and non-hormonal options. Our holistic approach to the care of the breast cancer survivor includes such preventive health issues as sexual and bone health,which are important in optimizing quality of life. We also discuss strategies for breast cancer recurrence surveillance in the setting of a prior breast cancer diagnosis. This review is intended for primary care practitioners as well as specialists caring for female breast cancer survivors and includes key points for evidence-based best practice recommendations.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast cancer; Contraception; Vasomotor symptoms; Vulvovaginal atrophy; Sexual health; Osteopenia; Osteoporosis; Breast cancer recurrence; Breast cancer surveillance Core tip: Caring for women with breast cancer at the time of diagnosis, during, and after treatment goes well beyond addressing the breast cancer alone. Holistic care includes safe, effective and convenient contraceptive options;local progestin intrauterine contraception may present an option for some breast cancer survivors. Discussion regarding the effects of chemotherapy on future fertility and pregnancy is an important part of survivorship care for women in child-bearing years. Addressing the effects of breast cancer treatment including vasomotor symptoms, vulvovaginal atrophy and sexual well-being is vital for all breast cancer survivors, but especially important in the setting of adjuvant therapy with aromatase inhibitors.

show abstract

“…Several meta-analyses have also reached to the same conclusion that pregnancy subsequent to breast cancer therapy does not impact the recurrence rate or overall survival (14)(15)(16). In an attempt to overcome a possible bias of a healthy mother effect a meta-analyses of nine studies comprising 1089 pregnancies and 13051 matched controls that had taken this in consideration found that a pregnancy occurring at least 10 months after diagnosis may result in a survival benefit (HR 0.51 95% CI: 0.42-0.62) (15).…”

Section: Pregnancy After Breast Cancer Treatmentmentioning

confidence: 99%

An overview of pregnancy and fertility issues in breast cancer patients

Dabrosin

2015

Annals of Medicine

View full text Add to dashboard Cite

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

show abstract

Safety of Pregnancy After Primary Breast Carcinoma in Young Women: A Meta-Analysis to Overcome Bias of Healthy Mother Effect Studies

Cited by 71 publications

References 22 publications

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

Caring for the breast cancer survivor’s health and well-being

An overview of pregnancy and fertility issues in breast cancer patients

Contact Info

Product

Resources

About