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Pregnancy after breast cancer: if you wish, ma’am

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Abstract

A growing number of young breast cancer survivors consider reproductive health issues, including subsequent fertility and pregnancy, of great importance, but many questions regarding safety remain unanswered. We conducted a comprehensive literature search and review of published articles, control-matched, population-based, and co-operative group reports that addressed various aspects of pregnancy after breast cancer (patients’ expectations, fertility damage, assessment and preservation, maternal and fetal outcome, breast feeding). Overall, available data support pregnancy and breast feeding after breast cancer as safe and feasible for women at low risk of recurrence. This retrospective and population-based evidence is, however, frequently incomplete; usually not representative of the entire population, it can be biased by patients’ related effects or underpowered and is often not controlled for biological factors and risk determinants in the statistical model used. Before making any definitive assumption on this delicate and fundamental aspect of a woman’s life after breast cancer, we should demonstrate without any reasonable doubt that the scattered information available today is scientifically sound. The Breast International Group and North American Breast Cancer Group are planning a global prospective study in young women with endocrine responsive, early breast cancer who desire pregnancy, to assess both patients’ and pregnancy outcomes. The trial will include an observational phase investigating the feasibility and impact of a temporary treatment interruption to allow conception and an experimental phase investigating the optimal duration of the subsequent endocrine treatment after delivery or the last failed attempt to get pregnant.

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Acknowledgments

The authors express their gratitude to Mrs Kris Vantongelen for coordinating the work of the Breast International Group and North American Breast Cancer Group Endocrine Working Group. The Breast International Group and the North American Breast Cancer Group Collaboration is supported by a grant of The Breast Cancer Research Foundation.

Conflict of interest

None.

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Authors and Affiliations

  1. Institute of Oncology of Southern Switzerland (IOSI) and International Breast Cancer Study Group (IBCSG), Ospedale Italiano, 6902, Viganello, Switzerland

    Olivia Pagani

  2. Dana-Farber Cancer Institute, Boston, MA, 02115, USA

    Ann Partridge

  3. Division of Medical Oncology, University of Washington, Seattle, WA, USA

    Larissa Korde

  4. Pathology and Lab Medicine, Indiana University, IN, 46260, Indianapolis, USA

    Sunil Badve

  5. Endocrine Cancer Group, Edinburgh Cancer Research Centre, Edinburgh, Scotland, UK

    John Bartlett

  6. Chicago Stritch School of Medicine, Loyola University, Maywood, IL, USA

    Kathy Albain

  7. IBCSG Statistical Center, Dana-Farber Cancer Institute, Frontier Science and Technology Research Foundation, Harvard School of Public Health and Harvard Medical School, Boston, MA, USA

    Richard Gelber

  8. Swiss Center for Breast Health, Lugano, Switzerland

    Aron Goldhirsch

  9. European Institute of Oncology, Milan, Italy

    Aron Goldhirsch

Authors
  1. Olivia Pagani
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  2. Ann Partridge
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  3. Larissa Korde
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  4. Sunil Badve
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  5. John Bartlett
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  6. Kathy Albain
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  7. Richard Gelber
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  8. Aron Goldhirsch
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Corresponding author

Correspondence to Olivia Pagani.

Additional information

This study was conducted on behalf of the Breast International Group (BIG) and North American Breast Cancer Group (NABCG) Endocrine Working Group. The members of this group are included under Appendix.

Appendix

Appendix

Members of the Breast International Group and North American Breast Cancer Group Endocrine Working Group: Aron Goldhirsch and Larissa Korde (Co-Chairs), Kathy Albain, Sunil Badve, John Bartlett, David Byrd, Kristine Calhoun, Peter Dubsky, Matthew Ellis, Richard Gelber, Michael Gnant, Olivia Pagani, Ann Partridge, Peggy Porter, Mahasti Saghatchian-d’Assignies, Christos Sotiriou, Laura van’t Veer, Eric Winer.

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Pagani, O., Partridge, A., Korde, L. et al. Pregnancy after breast cancer: if you wish, ma’am. Breast Cancer Res Treat 129, 309–317 (2011). https://doi.org/10.1007/s10549-011-1643-7

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  • DOI: https://doi.org/10.1007/s10549-011-1643-7

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