Obstetric Outcomes in Young Women with Breast Cancer: Prior, Postpartum, and Subsequent PregnanciesFunding Support This study was funded by grants NIH HD067221 (H.S.G.) and NIH 1P50CA138293–01A1 (V.K.G.).
11 September 2018
09 January 2019
06 February 2019 (online)
Objective This study aimed to describe obstetric outcomes in a large cohort of young women with breast cancer, considering the chronological relationship of pregnancies with breast cancer diagnosis.
Study Design From a population-based cohort study of young women with breast cancer from 2004 to 2010, we conducted secondary interviews to obtain detailed obstetric histories. Pregnancies were categorized based on timing of breast cancer diagnosis: prior, postpartum, and subsequent pregnancies after breast cancer diagnosis. A generalized estimated equation model was used to account for correlated data.
Results In this cohort (n = 366), median age at breast cancer diagnosis was 40.1 years, and 84.7% were Caucasian. Tumor type was notable for 25.1% triple negative, and 56.1% had Stage I disease. There were 922 prior pregnancies, 21 with postpartum diagnosis of breast cancer, and 24 pregnancies subsequent to breast cancer diagnosis. Non-live birth outcomes occurred significantly more often in the postpartum group (p-value: 0.001) compared with the other groups, which had higher live birth rates, after adjustment for maternal age, parity, body mass index, and race.
Conclusion Overall, pregnancy outcomes before and after breast cancer diagnosis are reassuring.
* These authors contributed equally to this article.
- 1 Howlader N, Noone AM, Krapcho M. , et al. SEER Cancer Statistics Review, 1975–2014. Available at: https://seer.cancer.gov/csr/1975_2014/ . Accesed June 8, 2017
- 2 Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 2003; 189 (04) 1128-1135
- 3 Eibye S, Kjær SK, Mellemkjær L. Incidence of pregnancy-associated cancer in Denmark, 1977-2006. Obstet Gynecol 2013; 122 (03) 608-617
- 4 Anderson BO, Petrek JA, Byrd DR, Senie RT, Borgen PI. Pregnancy influences breast cancer stage at diagnosis in women 30 years of age and younger. Ann Surg Oncol 1996; 3 (02) 204-211
- 5 Stensheim H, Møller B, van Dijk T, Fosså SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009; 27 (01) 45-51
- 6 Middleton LP, Amin M, Gwyn K, Theriault R, Sahin A. Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features. Cancer 2003; 98 (05) 1055-1060
- 7 Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer. A pilot survey of survivors' attitudes and experiences. Cancer 1999; 86 (04) 697-709
- 8 Lee SJ, Schover LR, Partridge AH. , et al; American Society of Clinical Oncology. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 2006; 24 (18) 2917-2931
- 9 Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in cancer patients. Fertil Steril 2005; 83 (06) 1622-1628
- 10 Azim Jr HA, Kroman N, Paesmans M. , et al. Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: a multicenter retrospective study. J Clin Oncol 2013; 31 (01) 73-79
- 11 Mueller BA, Simon MS, Deapen D, Kamineni A, Malone KE, Daling JR. Childbearing and survival after breast carcinoma in young women. Cancer 2003; 98 (06) 1131-1140
- 12 Azim Jr HA, Santoro L, Pavlidis N. , et al. Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies. Eur J Cancer 2011; 47 (01) 74-83
- 13 Li CI, Beaber EF, Tang MT, Porter PL, Daling JR, Malone KE. Reproductive factors and risk of estrogen receptor positive, triple-negative, and HER2-neu overexpressing breast cancer among women 20-44 years of age. Breast Cancer Res Treat 2013; 137 (02) 579-587
- 14 Li CI, Beaber EF, Tang MT, Porter PL, Daling JR, Malone KE. Effect of depo-medroxyprogesterone acetate on breast cancer risk among women 20 to 44 years of age. Cancer Res 2012; 72 (08) 2028-2035
- 15 Hahn KM, Johnson PH, Gordon N. , et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 2006; 107 (06) 1219-1226
- 16 Langagergaard V, Gislum M, Skriver MV. , et al. Birth outcome in women with breast cancer. Br J Cancer 2006; 94 (01) 142-146
- 17 Centers for Disease Control and Prevention. Breastfeeding Report Card: Progressing Toward National Breastfeeding Goals United States, 2016. Available at: https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf . Accessed August 18, 2017
- 18 Walton KA, Murray LJ, Gallagher AM, Cran GW, Savage MJ, Boreham C. Parental recall of birthweight: a good proxy for recorded birthweight?. Eur J Epidemiol 2000; 16 (09) 793-796
- 19 Yawn BP, Suman VJ, Jacobsen SJ. Maternal recall of distant pregnancy events. J Clin Epidemiol 1998; 51 (05) 399-405
- 20 Sou SC, Chen WJ, Hsieh WS, Jeng SF. Severe obstetric complications and birth characteristics in preterm or term delivery were accurately recalled by mothers. J Clin Epidemiol 2006; 59 (04) 429-435