Breast cancer survivor successfully conceives after treatment

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The study, presented at the press conference, American Society of Clinical Oncology (ASCO) Annual Meeting Successful pregnancy rates after treatment have been shown to be high: 73% of women with stage I to III breast cancer who tried to conceive were able to conceive and give birth to a live baby. However, the studies also suggest that certain factors may affect pregnancy success.

“Current research that helps us understand the impact of breast cancer treatment on pregnancy and lifetime live birth rates is fairly limited,” study author Kimia Sorouli, M.D., said in announcing the data. “This is the first prospective study with more than 10 years of follow-up to report on fertility outcomes in young breast cancer survivors who have attempted pregnancy.”

Solowri is a member of the Breast Cancer Program at the Dana-Farber Cancer Institute in Boston.

“Many young women diagnosed with breast cancer are concerned about their future fertility,” Solowri says, “but many cancer treatments can impair an individual's fertility and ability to continue a pregnancy.”

The study researchers analyzed data from a prospective study of breast cancer in young women: 1,213 patients under age 40 who were diagnosed with stage 0 to stage 3 breast cancer between 2006 and 2016. Of note, patients with metastatic disease or those who had had their uterus or ovaries removed were not included in the study.

Of these participants, 197 reported trying to conceive during an average follow-up period of 11 years. In this group, 73% reported at least one pregnancy, and 90% of these patients reported a live birth from at least one pregnancy. According to the data, the average time from diagnosis to first pregnancy was 48 months, and among the 197 women who reported pregnancy, the average age at the time of breast cancer diagnosis was 32 years.

Of the 197 patients who tried to conceive after diagnosis, approximately half (51%) reported being financially able, and 72% reported not having had a live birth prior to diagnosis. Twenty-eight percent of patients underwent fertility preservation (embryo and/or egg freezing). Additionally, 15% of patients had a history of infertility prior to their breast cancer diagnosis.

Regarding medical and treatment history of those who became pregnant, the majority (76%) had ER- and/or PR-positive disease, followed by HER2-positive disease (25%) and triple-negative breast cancer (17%).

Sixty-eight percent of patients received chemotherapy, 57% received endocrine therapy, 58% received radiation therapy, 38% underwent partial mastectomy (surgical removal of part of the breast tissue to remove the cancer), 22% underwent unilateral mastectomy (surgical removal of one breast), and 41% underwent bilateral mastectomy (surgical removal of both breasts).

Pregnancy-related factors

The data showed that factors that increase the chances of conceiving include being younger at the time of diagnosis, being financially well off (defined as having enough money left over to “buy something special” after paying bills), and having fertility-sparing surgery.

“Having fertility-sparing surgery at diagnosis, before undergoing cancer treatment, was a predictor of live birth, but other patient cancer and treatment factors collected were not associated with either outcome,” Solowri said.

The researchers also found that some factors don't seem to affect the chances of getting pregnant or having a baby, including:

• History of infertility
• Previous births
• Characteristics of Breast Cancer
• Type of treatment received
• BRCA germline mutation status
• Race or ethnicity

“This suggests that in contemporary cohorts where fertility is more conscious, access to fertility preservation therapies may help mitigate some of the damage caused by chemotherapy and other agents,” Solowri said. “Importantly, it highlights the need for improved access to fertility preservation services for newly diagnosed women with breast cancer who are interested in future pregnancies.”