A systematic review and meta-analysis confirmed that patients who survived breast cancer can achieve a safe and successful pregnancy. These findings were published in the Journal of Clinical Oncology.
There may be concern among both patients and physicians about whether a breast cancer survivor should attempt a pregnancy. To understand the most up-to-date data on the subject, researchers performed a publication search through October of 2020 for relevant studies.
A total of 39 studies comprising 8,093,401 patients met the inclusion criteria. Among this patient population, 112,840 had breast cancer and 7505 of whom had a pregnancy after diagnosis.
Cancer was found to reduce the likelihood of pregnancy by 35% (relative risk [RR], 0.65; 95% CI, 0.55-0.77) overall, in which pregnancy was most greatly reduced among women with cervical cancer. For breast cancer, survivors had a pregnancy reduction of 60% (RR, 0.40; 95% CI, 0.32-0.49).
For reproductive outcomes, the investigators noted no difference between breast cancer survivors and the general population for birth defects (odds ratio [OR], 1.63; 95% CI, 0.89-2.98), induced abortion (OR, 1.40; 95% CI, 0.71-2.76), completed pregnancy (OR, 1.21; 95% CI, 0.48-3.03), spontaneous abortion (OR, 1.04; 95% CI, 0.86-1.26), pre-eclampsia (OR, 1.03; 0.27-3.98), or postpartum bleeding (OR, 0.88; 95% CI, 0.57-1.37).
However, breast cancer associated with increased risk for low birth weight (OR, 1.50; 95% CI, 1.31-1.73), preterm birth (OR, 1.45; 95% CI, 1.11-1.88), small-for-gestational-age (OR, 1.16; 95% CI, 1.01-1.33), and caesarean section (OR, 1.14; 95% CI, 1.04-1.25).
The study authors found high study heterogeneity in some of these analyses, especially among the assessments for maternal safety.
These data indicated that for many women who survive breast cancer, a successful pregnancy is possible and that all younger women with breast cancer should receive oncofertility counselling.
Disclosure: Multiple authors declared affiliations with biotech, pharmaceutical and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Lambertini M, Blondeaux E, Bruzzone M, et al. Pregnancy after breast cancer: a systematic review and meta-analysis. J Clin Oncol. 2021;39(29):3293-3305. doi:10.1200/JCO.21.00535