Trends and factors related to pregnancy after breast cancer treatment in young patients.

Abstract

e24095 Background: In women of reproductive age who have been treated for breast cancer (BC), interest in fertility preservation (FP) is as important as treatment. Although methods for FP are already well known, sufficient information is not provided about the pregnancy results at specified BC stage or treatment. This study was designed to retrospectively analyze and provide information on fertility preservation attempts and actual pregnancy in women of childbearing age who had been diagnosed with BC for the past 10 years. Methods: We retrospectively reviewed women of childbearing age (18-40 years) with treated at single tertiary medical center from December 2010 to September 2020. The relationship between the tumor characteristics and treatments and actual pregnancy was analyzed. Time from diagnosis to pregnancy was analyzed according to tumor characteristics and treatments. During the period, intensive education on FP was offered to the patients from 2014, and whether there were any changes in the results before and after this was also analyzed. Results: A total of 1033 patients were included, representing 115 patients who were pregnant during the observation period. Overall, 519 (50.2%) patients were offered fertility counseling, 81 (7.8%) patients get oocytes or embryos preservation and 456 (44.1%) patients underwent Gonadotrophin hormone receptor analogue (GnRHa) for FP. Our analysis showed differences in pregnancy rates for age at diagnosis ( P= .002), HR (Hormone receptor) status ( P=.015), and hormonal therapy ( P= .004), among them, there was a significant difference in pregnancy timing only for HR (2.53 vs 3.42 years, P= .009) and hormonal therapy (2.39 vs 3.56 years, P<.001). There were 93 patients who stopped taking tamoxifen for preparing pregnancy, and 53 patients succeeded in becoming pregnant. In this cohort there were no significant difference in pregnancy rate for age, tumor characteristics, stage and treatments. Conclusions: Tumor characteristics which required endocrine therapy was related to the pregnancy rate and time to conception. However, more than half of the women who actively consulted with their doctor for pregnancy and interrupted endocrine therapy within first five years had a successful pregnancy and also were not inferior in disease free survival. Most of FP was still predominantly underwent with concurrent GnRHa use. In young women who want to preserve fertility, it is important to provide such information and make mutual decisions for active FP.[Table: see text]