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Prognostic role of pregnancy occurring before or after treatment of early breast cancer patients aged <35 years†

A GET(N)A Working Group analysis

  1. Rémy Largillier MD1,2,‡,*,
  2. Alexia Savignoni MD3,
  3. Joseph Gligorov MD4,
  4. Philippe Chollet MD, PhD5,
  5. Marie-Noëlle Guilhaume MD3,
  6. Marc Spielmann MD6,
  7. Elisabeth Luporsi MD7,
  8. Bernard Asselain MD3,
  9. Bruno Coudert MD8,
  10. Moïse Namer MD, PhD1,2,
  11. on behalf of the GET(N)A Group1,2

Article first published online: 18 AUG 2009

DOI: 10.1002/cncr.24608

Issue

Cancer

Cancer

Volume 115, Issue 22, pages 5155–5165, 15 November 2009

Additional Information

How to Cite

Largillier, R., Savignoni, A., Gligorov, J., Chollet, P., Guilhaume, M.-N., Spielmann, M., Luporsi, E., Asselain, B., Coudert, B., Namer, M. and on behalf of the GET(N)A Group (2009), Prognostic role of pregnancy occurring before or after treatment of early breast cancer patients aged <35 years. Cancer, 115: 5155–5165. doi: 10.1002/cncr.24608

Author Information

  1. 1

    Department of Medical Oncology, Centre Azuréen de Cancérologie, Mougins, France

  2. 2

    Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France

  3. 3

    Department of Biostatistics, Institut Curie, Paris, France

  4. 4

    Department of Medical Oncology, Hôpital Tenon, Paris, France

  5. 5

    Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France

  6. 6

    Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France

  7. 7

    Department of Medical Oncology, Centre Alexis Vautrin, Nancy, France

  8. 8

    Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France

  1. ‡

    Fax: (011) 33 4 92 92 37 47

*Centre Azuréen de Cancérologie, 1 place du Docteur Broquerie, 06250 Mougins, France

  1. †

    Isabelle Chapelle-Marcillac provided editorial assistance in the preparation of the manuscript.

Publication History

  1. Issue published online: 3 NOV 2009
  2. Article first published online: 18 AUG 2009
  3. Manuscript Accepted: 8 APR 2009
  4. Manuscript Revised: 13 MAR 2009
  5. Manuscript Received: 5 DEC 2008

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Keywords:

  • pregnancy;
  • early breast cancer;
  • young patients;
  • survival

Abstract

BACKGROUND:

Usual practices recommend waiting at least 2 years between diagnosis of early breast cancer (EBC) and pregnancy. Few data highlighted a harmful effect of an early pregnancy for low-risk patients. The authors analyzed retrospectively data from women younger than 35 years who became pregnant before or after treatment of EBC.

METHODS:

Between 1990 and 1999, 908 consecutive EBC patients were analyzed. The primary endpoint was to compare overall survival (OS) between pregnant and nonpregnant patients. The secondary endpoint was to establish a score index laying down the risk of distant recurrence.

RESULTS:

Within the year before the diagnosis, 105 (11.6%) patients became pregnant and 118 (13%) were pregnant after treatment. In a multivariate model, a pregnancy before the diagnosis was not predictive of death but of local relapse. A pregnancy subsequent to breast cancer therapy resulted in a 77% decrease of death (P < .001). In good-prognosis score index patients, the annual risk of relapse remained low. In patients having the higher score, recurrences occurred mainly during the first years after the treatment. Beyond 80 months, the annual risk of relapse seemed to be similar to those of lower-risk subgroups.

CONCLUSIONS:

In women aged younger than 35 years, a pregnancy occurring before or after the diagnosis of breast cancer was not an independent prognostic factor of death. In the subset of patients having a high risk of relapse, it may be preferable to postpone a pregnancy beyond 5 years after the breast cancer therapy. Cancer 2009. © 2009 American Cancer Society.

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