Pregnancy after Treatment of Breast Cancer

Abstract

Thanks to improvement in cancer patients treatment results, growing attention has been paid to fertility issues. Physicians should discuss infertility risk and the possibilities of fertility preservation with all patients in reproductive age as soon as possible. Pregnancy in cancer survivors after adequate treatment should not be discouraged, including patients with endocrine-sensitive breast cancer. Embryo and oocyte cryopreservation are standard strategies for fertility cryopreservation. Several randomized clinical trials have addressed the role of LHRHa (luteinizing hormone-releasing hormone analogs) as a way of fertility preservation with conflicting results. A meta-analysis of clinical trials, including also the largest trials POEMS and PROMISE, showed higher odds of achieving pregnancy. These data suggest that giving LHRHa before and during adjuvant chemotherapy could also be a reliable strategy to preserve ovarian function and fertility. The use of ovarian stimulating drugs in standard treatment protocols for ovarian stimulation in female cancer patients is safe according to current data. The meta-analysis of 14 studies did not show negative influence of pregnancy on overall survival of female cancer patients although the optimal interval between breast cancer diagnosis and pregnancy is not known. However, breast cancer patients are in higher risk of preterm labor and low birth weight of infants.Key words: breast neoplasms - fertility preservation - ovarian stimulation - LHRH - pregnancy - tamoxifen - aromatase inhibitors - adjuvant hormonal therapyThis work was supported by MEYS - NPS I - LO1413.The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 3. 8. 2016Accepted: 11. 8. 2016.