Safety of pregnancy after breast cancer in young women with hormone receptor-positive disease: a systematic review and meta-analysis

被引：16

作者：

Arecco, L. ^{[1
,2
]}

Blondeaux, E. ^{[3
]}

Bruzzone, M. ^{[3
]}

Latocca, M. M.

Mariamidze, E. ^{[4
]}

Begijanashvili, S. ^{[5
]}

Sokolovic, E. ^{[6
]}

Gentile, G. ^{[7
]}

Scavone, G. ^{[2
]}

Ottonello, S. ^{[2
]}

Boutros, A. ^{[1
,8
]}

Vaz-Luis, I. ^{[9
,10
]}

Saura, C. ^{[11
]}

Anderson, R. A. ^{[12
]}

Demeestere, I. ^{[2
,13
]}

Azim Jr, H. A. ^{[14
]}

de Azambuja, E. ^{[15
,16
]}

Peccatori, F. A. ^{[17
]}

Del Mastro, L. ^{[1
,2
]}

Partridge, A. H. ^{[18
]}

Lambertini, M. ^{[1
,2
,19
]}

机构：

[1] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Genoa, Italy

[2] IRCCS Osped Policlin San Martino, Dept Med Oncol, UOC Clin Oncol Med, Genoa, Italy

[3] IRCCS Osped Policlin San Martino, UO Clin Epidemiol Unit, Genoa, Italy

[4] Todua Clin, Dept Oncol & Hematol, Tbilisi, Georgia

[5] Amer Hosp, Dept Clin Oncol, Tbilisi, Georgia

[6] Clin Ctr Univ Sarajevo, Clin Oncol, Sarajevo, Bosnia & Herceg

[7] Sapienza Univ Rome, Dept Radiol Oncol & Pathol, Med Oncol Unit B, Rome, Italy

[8] IRCCS Osped Policlin San Martino, Dept Med Oncol, Oncol Med 2, Genoa, Italy

[9] INSERM, Interdisciplinary Dept Org Patient Pathways DIOPP), Unit Mol Predictors & New Targets Oncol 981, Paris, France

[10] Inst Gustave Roussy, Paris, France

[11] Vall dHebron Univ Hosp, Med Oncol Serv, Breast Canc Unit, Barcelona, Spain

[12] Univ Edinburgh, MRC Ctr Reprod Hlth, Edinburgh, Scotland

[13] Fertil Clin HUB Erasme, Res Lab Human Reprod, Brussels, Belgium

[14] Tecnol Monterrey, Hosp Zambrano Hell, Breast Canc Ctr, San Pedro Garza Garcia, Nuevo Leon, Mexico

[15] Inst Jules Bordet, Acad Trials Promoting Team, Brussels, Belgium

[16] Univ Libre Bruxelles ULB, Brussels, Belgium

[17] European Inst Oncol IRCCS, Gynecol Oncol Program, Fertil & Procreat Unit, I-20141 Milan, Italy

[18] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA USA

[19] Univ Genoa, IRCCS Osped Policlin San Martino, Largo Rosanna Benzi 10, I-16132 Genoa, Italy

来源：

ESMO OPEN | 2023年 / 8卷 / 06期

关键词：

pregnancy; breast cancer; hormone receptor-positive disease; premenopausal patients; oncofertility; ENDOCRINE THERAPY; FERTILITY; PRESERVATION; RECURRENCE; KNOWLEDGE; ATTITUDES; SURVIVAL; ESTROGEN; ISSUES; IMPACT;

D O I：

10.1016/j.esmoop.2023.102031

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Despite increasing evidence on the safety of pregnancy after anticancer treatments in breast cancer survivors, many physicians and patients remain concerned about a potential risk of pregnancy specifically in the case of hormone receptor-positive breast cancer. Materials and methods: A systematic literature search of Medline, Embase and Cochrane library with no language or date restriction up to 31 March 2023 was carried out. To be included, articles had to be retrospective and prospective case-control and cohort studies as well as clinical trials comparing survival outcomes of premenopausal women with or without a pregnancy after prior diagnosis of hormone receptor-positive breast cancer. Disease-free survival (DFS) and overall survival (OS) were the outcomes of interest. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Study protocol is registered in PROSPERO (n. CRD42023394232). Results: Out of 7796 screened studies, 8 were eligible to be included in the final analysis. A total of 3805 patients with hormone receptor-positive invasive early breast cancer were included in these studies, of whom 1285 had a pregnancy after breast cancer diagnosis. Median follow-up time ranged from 3.8 to 15.8 years and was similar in the pregnancy and non-pregnancy cohorts. In three studies (n = 987 patients) reporting on DFS, no difference was observed between patients with and those without a subsequent pregnancy (HR 0.96, 95% CI 0.75-1.24, P = 0.781). In the six studies (n = 3504 patients) reporting on OS, patients with a pregnancy after breast cancer had a statistically significant better OS than those without a pregnancy (HR 0.46, 95% CI 0.27-0.77, P < 0.05). Conclusions: This systematic review and meta-analysis of retrospective cohort studies provides updated evidence that having a pregnancy in patients with prior history of hormone receptor-positive invasive early breast cancer appears safe without detrimental effect on prognosis.

引用

页数：9

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