Pregnancy Subsequent to Mastectomy for Cancer of the Breast

Cooper, Donald R.; Butterfield, Jeanne

doi:10.1097/00000658-197003000-00017

Cited by 81 publications

(13 citation statements)

References 2 publications

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“…64,65 Finally, patients' and physicians' concerns about a potential negative impact of prior breast cancer diagnosis and treatment on reproductive outcomes and maternal safety may have played a major role in discouraging many survivors from attempting pregnancy. 15,16 These highly relevant issues have been dispelled by the present meta-analysis.…”

Section: Discussionmentioning

confidence: 92%

“…13,14 In addition, many women and their treating physicians remain concerned about the safety for both offspring and mother of pregnancy following breast cancer diagnosis and treatment. 15,16 The main reasons for this distress are the possibility that a prior exposure to anticancer therapies might have negative effects on the fetus by increasing the risk of congenital abnormalities, obstetric, or birth complications. Furthermore, as breast cancer is a hormonal-driven tumor and considering the surge in female hormones during pregnancy, there is a general concern that pregnancy could increase patients' risk of recurrence.…”

Section: Manuscript Introductionmentioning

confidence: 99%

“…Furthermore, as breast cancer is a hormonal-driven tumor and considering the surge in female hormones during pregnancy, there is a general concern that pregnancy could increase patients' risk of recurrence. 15,16 Current guidelines do not discourage having a pregnancy following treatment completion for breast cancer and an adequate period of follow-up. 6,17 However, only a small number of breast cancer patients do conceive.…”

Section: Manuscript Introductionmentioning

confidence: 99%

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Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis

Lambertini

Blondeaux

Bruzzone

et al. 2021

JCO

104

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PURPOSE Many patients and physicians remain concerned about the potential detrimental effects of pregnancy after breast cancer (BC) in terms of reproductive outcomes and maternal safety. This systematic review and meta-analysis aimed at providing updated evidence on these topics. METHODS A systematic literature review was conducted to identify studies including patients with a pregnancy after BC (PROSPERO number CRD42020158324). Likelihood of pregnancy after BC, their reproductive outcomes, and maternal safety were assessed. Pooled relative risks, odds ratios (ORs), and hazard ratios (HRs) with 95% CIs were calculated using random effects models. RESULTS Of 6,462 identified records, 39 were included involving 8,093,401 women from the general population and 112,840 patients with BC of whom 7,505 had a pregnancy after diagnosis. BC survivors were significantly less likely to have a subsequent pregnancy compared with the general population (relative risk, 0.40; 95% CI, 0.32 to 0.49). Risks of caesarean section (OR, 1.14; 95% CI, 1.04 to 1.25), low birth weight (OR, 1.50; 95% CI, 1.31 to 1.73), preterm birth (OR, 1.45; 95% CI, 1.11 to 1.88), and small for gestational age (OR, 1.16; 95% CI, 1.01 to 1.33) were significantly higher in BC survivors, particularly in those with previous chemotherapy exposure, compared with the general population. No significantly increased risk of congenital abnormalities or other reproductive complications were observed. Compared to patients with BC without subsequent pregnancy, those with a pregnancy had better disease-free survival (HR, 0.66; 95% CI, 0.49 to 0.89) and overall survival (HR, 0.56; 95% CI, 0.45 to 0.68). Similar results were observed after correcting for potential confounders and irrespective of patient, tumor, and treatment characteristics, pregnancy outcome, and timing of pregnancy. CONCLUSION These results provide reassuring evidence on the safety of conceiving in BC survivors. Patients' pregnancy desire should be considered a crucial component of their survivorship care plan.

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Section: Discussionmentioning

confidence: 92%

Section: Manuscript Introductionmentioning

confidence: 99%

Section: Manuscript Introductionmentioning

confidence: 99%

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Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis

Lambertini

Blondeaux

Bruzzone

et al. 2021

JCO

104

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“…Other authors have refuted this, showing no worse outcome with subsequent pregnancy 41−43 . In fact, women who have a subsequent pregnancy have equivalent or, possibly, better survival matched for stage 2,7 , 15,44−48 . Although this suggests that subsequent pregnancy may provide a survival benefit, there may be bias involved, with only a select group of women who feel healthy generally going on to become pregnant: a ‘healthy mother’ effect 49 …”

Section: Subsequent Pregnancymentioning

confidence: 99%

Breast cancer and pregnancy: a diagnostic and management dilemma

Puckridge

Saunders

Ives

et al. 2002

ANZ Journal of Surgery

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“…Some data exist demonstrating that pregnancy subsequent to diagnosed breast cancer is protective (Cooper & Butterfield 1970), and there is certainly no evidence that it is clearly detrimental. These observations question the current assumption that giving hormone replacement therapy in known cases of breast cancer reduces survival.…”

mentioning

confidence: 99%