Sistema de Salut de Catalunya
Institut Català de la Salut
[Arecco L] Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova. Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova. [Blondeaux E, Bruzzone M] U.O. Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy. [Latocca MM] Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova. [Mariamidze E] Department of Oncology and Hematology, Todua Clinic, Tbilisi. [Begijanashvili S] Department of Clinical Oncology, American Hospital, Tbilisi, Georgia. [Saura C] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-11-08T13:45:20Z
2023-11-08T13:45:20Z
2023-12
Breast cancer; Oncofertility; Pregnancy
Càncer de mama; Oncofertilitat; Embaràs
Cáncer de mama; Oncofertilidad; Embarazo
Background Despite increasing evidence on the safety of pregnancy after anticancer treatments in breast cancer survivors, many physicians and patients remain concerned about a potential risk of pregnancy specifically in the case of hormone receptor-positive breast cancer. Materials and methods A systematic literature search of Medline, Embase and Cochrane library with no language or date restriction up to 31 March 2023 was carried out. To be included, articles had to be retrospective and prospective case-control and cohort studies as well as clinical trials comparing survival outcomes of premenopausal women with or without a pregnancy after prior diagnosis of hormone receptor-positive breast cancer. Disease-free survival (DFS) and overall survival (OS) were the outcomes of interest. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Study protocol is registered in PROSPERO (n. CRD42023394232). Results Out of 7796 screened studies, 8 were eligible to be included in the final analysis. A total of 3805 patients with hormone receptor-positive invasive early breast cancer were included in these studies, of whom 1285 had a pregnancy after breast cancer diagnosis. Median follow-up time ranged from 3.8 to 15.8 years and was similar in the pregnancy and non-pregnancy cohorts. In three studies (n = 987 patients) reporting on DFS, no difference was observed between patients with and those without a subsequent pregnancy (HR 0.96, 95% CI 0.75-1.24, P = 0.781). In the six studies (n = 3504 patients) reporting on OS, patients with a pregnancy after breast cancer had a statistically significant better OS than those without a pregnancy (HR 0.46, 95% CI 0.27-0.77, P < 0.05). Conclusions This systematic review and meta-analysis of retrospective cohort studies provides updated evidence that having a pregnancy in patients with prior history of hormone receptor-positive invasive early breast cancer appears safe without detrimental effect on prognosis.
This work was partially supported by the Italian Association for Cancer Research (‘Associazione Italiana per la Ricerca sul Cancro’, AIRC) [grant number MFAG 2020 ID 24698] and by Italian Ministry of Health—5 x 1000 funds (years 2021-2022).
Article
Published version
English
Embaràs; Mama - Càncer; DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms; PHENOMENA AND PROCESSES::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproduction::Pregnancy; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama; FENÓMENOS Y PROCESOS::fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::reproducción::embarazo
Elsevier
ESMO Open;8(6)
https://doi.org/10.1016/j.esmoop.2023.102031
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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