Findings of a Retrospective cohort study presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting reassure women that it is safe to become pregnant after surviving breast cancer and they do not face an increase chance of recurrences because of pregnancy.
“These data
provide reassurance to breast cancer survivors that having a baby after a
breast cancer diagnosis may not increase the chance of their cancer coming
back. For many young women around the world who want to grow and expand their
families, it’s very comforting news,” said Erica L. Mayer, MD, MPH, ASCO
Expert.
This study
of 1,207 patients is the largest study till date to examine the safety of pregnancy
after breast cancer, specifically in those women who have the most common type
of ER-positive caner.
According to
The PREFER (Pregnancy and Fertility) trial, approximately 4.5% of breast
cancers are diagnosed in women younger than 40 years.
The women
were under the age of 50, with non-metastatic disease,57% had ER-positive
cancer and more than 40% had poor prognostic factors like large tumor size with
positive axillary lymph nodes.
Nearly 28%
of patient (333) become pregnant with median time to conception of 2.4 years.
Those with ER positive had difficulty achieving pregnancy as compared to ER
negative diagnosis.
Each patient
who become pregnant was matched to 3 patients with similar cancer demographics
but no pregnancy.
After a
median follow up of 10 years, the disease-free survival rate in both the groups
were comparable irrespective of ER status, spontaneous abortion or term
pregnancy, time to pregnancy less than or more than 2 years or breast feeding. (hazard
ratio [HR], 0.85; P = .15).
ER negative
patient who conceived had a 42% better chance of survival as compared to those
who was not able to conceive. (HR, 0.58; P = .01)
Dr. Matteo Lambertini,
MD, lead study author and a medical oncologist at the Institut Jules Bordet in
Brussels, Belgium said, “It’s possible that pregnancy could be a protective
factor for patients with ER-negative breast cancer, through either immune
system mechanisms or hormonal mechanisms, but we need more research into this.”
He further
added that pregnancy after Breast Cancer is “safe” and “should not be discouraged”
during a press conference.
A prospective Pregnancy Outcome and Safety of
Interrupting Therapy for Women with Endocrine Responsive Breast Cancer
(POSITIVE) study is currently ongoing. This study will provide important inputs
into results of temporary stopping the hormone therapy for pregnancy in women
with ER-positive breast cancer.
The
researchers are also looking at how women with BRCA mutations will fare in
pregnancy as these group of women develop the cancer at much early age and have a long reproductive life ahead.
Full text of
the ASCO news release can be accessed here.
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