Sunday, June 4, 2017

News from ASCO 2017: Pregnancy after breast cancer is feasible and safe



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.  





2 comments:

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