Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer

Abstract

†A complete list of the members of the International Breast Cancer Study Group (IBCSG), a division of the ETOP IBCSG Partners Foundation, and lists of the study groups, steering committee members, and investigators participating in the POSITIVE trial are provided in the Supplementary Appendix, available at NEJM.org.

UpToDate®

“…In a study in 516 patients with early breast cancer who had received adjuvant endocrine therapy for 18 to 30 months and desired pregnancy, endocrine therapy was interrupted upon enrollment, and pregnancy occurred in 74 percent. 4 The three-year rate of breast cancer events was 8.9 percent, which was similar to the rate in an external control group who met study entry criteria aside from desire for pregnancy and treatment interruption (9.2 percent). These data suggest that endocrine therapy interruption for pregnancy does not increase short-term risks of breast cancer recurrence, but longer-term data are required.…”

Pregnancy After Breast Cancer in Young BRCA Carriers

“…Nevertheless, 60% of pregnancies in patients with hormone receptor–positive breast cancer occurred within 5 years of diagnosis. This percentage is expected to increase based on the reassuring early results of the POSITIVE trial showing the safety of temporary interruption of endocrine therapy to attempt pregnancy 18 to 30 months into endocrine therapy …”

“…In our study, more than half of these patients had a pregnancy within the first 5 years, and timing of pregnancy after breast cancer did not appear to affect the results. Long-term follow-up of the POSITIVE trial, which included a small group of BRCA carriers, will provide further evidence in this regard.…”

Behandlung des frühen Mammakarzinoms – 18. Internationaler St.-Gallen-Konsens vor dem Hintergrund der aktuellen deutschen Therapieempfehlungen diskutiert

“…Die ersten Ergebnisse der POSITIVE-Studie [3] weisen darauf hin, dass junge Frauen mit einem frühen hormonrezeptorpositiven (HR+) Mammakarzinom die Behandlung nach mindestens 18-monatiger adjuvanter endokriner Therapie unter bestimmten Bedingungen vorübergehend unterbrechen können, um schwanger zu werden. Das SGBCC-Panel rät einer Frau mit HR+ Mammakarzinom und mindestens 4 befallenen Lymphknoten in der Axilla, die seit 2 Jahren Tamoxifen plus OFS (ovarielle Funktionssuppression) erhält, von einer Unterbrechung der endokrinen Therapie ab (Mehrheitsvotum: 78,57 %).…”

“…Die deutschen Expertinnen und Experten verweisen auf das hohe Rückfallrisiko in dieser Situation mit initial mindestens 4 befallenen Lymphknoten und stimmen dem SGBCC-Mehrheitsvotum zu. Zudem wurden in der POSITIVE-Studie [3] primär "Low-Risk"-Patientinnen aufgenommennur 6 % (n = 31/516) hatten ein Mammakarzinom im Stadium III. Die oben genannte Situation wird durch die Studienergebnisse nicht (adäquat) abgebildet.…”