After breast cancer, live birth may increase overall survival
According
to a study presented at ESHRE 2022, women who become pregnant and give birth to
a live child after receiving a breast cancer diagnosis may experience better
overall survival (OS) results than women who do not give birth to live children
after receiving a diagnosis.
According
to research author Professor Richard Anderson of the Medical Research Council
Centre for Reproductive Health, University of Edinburgh, Scotland, "our
analysis showed that having a baby after breast cancer doesn't have a negative
influence on survival."
According
to Anderson and co-authors, "OS was elevated among women who had a live
birth after breast cancer, especially in those aged 30 [years] at diagnosis and
without a previous live birth."
The
authors located 5,181 women under the age of 40 who received a breast cancer
diagnosis between 1981 and 2017 using data from the Scottish Cancer Registry (n
= 5,181). Up until the end of 2018, pregnancies were included, and the study
entry date was the date of the live birth.
290
ladies gave birth to live children after receiving a breast cancer diagnosis.
Each breast cancer patient who gave birth alive was matched with up to six
control cases (no live birth) who had received a breast cancer diagnosis in the
same year and were still living when the matched patient gave birth alive.
Following
a breast cancer diagnosis, OS was better for women who gave birth to a live
child compared to those who did not (hazard ratio [HR], 0.65; 95 percent
confidence interval [CI], 0.50-0.85; p=0.0015). Abstract O-196 from ESHRE 2022
This
enhanced survival among post-cancer live-birthing women was only shown in those
who had not been pregnant before receiving a breast cancer diagnosis (HR, 0.56,
95 percent CI, 0.38-0.82, p=0.003) and not in those who had (HR, 0.76, 95
percent CI, 0.53–1.09).
Regardless
of whether the cancer was discovered at stage 1 (HR, 0.74, 95 per cent CI,
0.40-1.35) or stage 2-3, there did not seem to be a substantial survival
benefit following live birth when breast cancer was evaluated by stage (HR,
0.71, 95 per cent CI, 0.37–1.37).
The
impact of better OS following a live delivery varied by age, with the highest
impact shown in women diagnosed with cancer between the ages of 20 and 25 (HR,
0.30, 95 per cent CI, 0.12-0.74; p=0.009) and 26 and 30 (HR, 0.58, 95 per cent
CI, 0.38-0.88; p=0.011). In women diagnosed between the ages of 31 and 36 and
36 and 39, live birth did not substantially alter OS (HR, 0.67, 95 per cent CI,
0.44-1.01; p=0.057 and HR, 0.89, 95 per cent CI, 0.42-1.87; p=0.76,
respectively).
The
majority of women (n=182) gave birth to a live child within five years after
receiving a breast cancer diagnosis, and OS was higher in this group compared
to those who did not give birth to a live child after diagnosis (HR, 0.66, 95
per cent CI, 0.49-0.89; p=0.006). On the other hand, there was no OS benefit
after a live birth that took place about 5 years after a cancer diagnosis (HR,
0.63, 95per cent CI, 0.36–1.13).
According
to Anderson and co-authors, "being a hormone-sensitive malignancy, there
has long been a worry among patients and doctors that having a subsequent
pregnancy and live baby might affect recurrence and survival."
However,
they noted that there is little evidence for this due to the paucity of data on
patient characteristics that can affect results.
They
said, "This is of increasing concern given that more women with breast
cancer will not have begun or finished their family due to the rising age [of
women during pregnancy]."
The
growing number of women who wish to begin or finish their families after
receiving breast cancer treatment will find comfort in [the study's outcomes],
Anderson said.