Pregnancy does not adversely affect the prognosis of women who have previously been treated for early stage breast cancer, according to a recent article published in the Journal of Clinical Oncology.
Breast cancer is a common malignancy among women. One-quarter of breast cancer cases occur in women prior to menopause, at an age in which bearing children may be an important consideration. However, concern has arisen regarding the effects of pregnancy in women who have already been diagnosed with breast cancer. This concern stems from the fact that breast cancer can be stimulated to grow by various endocrine signals, particularly the female hormones estrogen and/or progesterone. During pregnancy, complex endocrine processes are evoked within a woman’s body, with estrogen and/or progesterone levels soaring throughout the course of the term. This has left physicians and patients worried about the effects of pregnancy in raising the risk of a cancer recurrence in women who have already been diagnosed and treated for breast cancer.
Researchers from the International Breast Cancer Study Group (IBSCG) and the Department of Biostatistical Science recently evaluated data compiled from multiple institutions involving long-term outcomes of women treated for breast cancer. Nearly 100 women who had been diagnosed and successfully treated for early stage breast cancer and who later became pregnant were followed. Long-term results from this group of women were compared to women with matched age, treatment and disease diagnoses who did not become pregnant.
In the group of women who became pregnant, overall survival was 92% at 5 years following diagnosis and 86% at 10 years following diagnosis. In the group of women who did not become pregnant, overall survival was 85% at 5 years following diagnosis and 74% at 10 years following diagnosis.
These results are consistent with 5 previous clinical studies evaluating the survival effects of pregnancy in breast cancer patients
1,2,3,4,5. Interestingly, the other trials also reported a long-term survival increase for women who had subsequent pregnancies following treatment for their cancer. Although it is too early to speculate that pregnancy may have a beneficial effect in this group of patients, further investigation is warranted.
Although these results indicate that a woman who has been treated for early breast cancer will not suffer a worse prognosis following pregnancy, it is imperative that patients speak with their physician regarding the decision to have children, as every case hinges on individual variables. (Journal of Clinical Oncology, Vol 19, No 6, pp 1671-1675, 2001)
1 von Schoultz et al.
Journal of Clinical Oncology, Vol 13, pp 430-434, 1995
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2 Kroman et al.
Lancet, Vol 350, pp 319-322, 1997
3 Sankila et al.
American Journal of Obstetrics and Gynecology, Vol 170, pp 818-823, 1994
4 Velentgas et al.
Cancer, Vol 85, pp 2424-2432, 1999
5 Ludwig Breast Cancer Study Group,
New England Journal of Medicine, Vol 319, pp 677-683, 1988
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