BMJ  2007;334:194 (27 January), doi:10.1136/bmj.39035.667176.55 (published 8 December 2006)

Research

Pregnancy after breast cancer: population based study

¹ School of Surgery and Pathology (M507), University of Western Australia, Crawley, Western Australia 6009, ² School of Population Health (M431), University of Western Australia, Crawley, Western Australia 6009, ³ School of Public Health, Curtin University of Technology, Bentley, Western Australia 6845

Objectives To identify women who survived breast cancer and subsequently conceived and to determine the rate of pregnancy (proportion), management, outcome of the cancer, and outcome of the first subsequent pregnancy.

Design Population based descriptive study with cases identified from the Western Australian data linkage system and validated by review of medical charts. Supplementary data obtained from hospital and clinician records.

Setting Western Australia, 1982-2003.

Participants Women aged <45 with a diagnosis of breast cancer who subsequently conceived.

Main outcome measures Pregnancy outcome and rate, survival, time from diagnosis to pregnancy.

Results Sixty two (54%) women with a diagnosis of breast cancer who subsequently conceived did so less than two years after their diagnosis: 29 of them had an abortion, 27 had a live birth, and six miscarried. Within a proportional hazards regression model subsequent pregnancy was associated with improved overall survival (hazard ratio 0.59, 95% confidence interval 0.37 to 0.95). When the model was stratified by time from diagnosis subsequent pregnancy was associated with improved overall survival in women who waited at least 24 months to conceive (0.48, 0.27 to 0.83) and a non-significant protective effect was seen for women who waited at least six months to become pregnant.

Conclusions Our study does not support the current medical advice given to premenopausal women with a diagnosis of with breast cancer to wait two years before attempting to conceive. This recommendation may be valid for women who are receiving treatment or have systemic disease at diagnosis, but for women with localised disease early conception, six months after completing their treatment, is unlikely to reduce survival.

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Rapid Responses:

Read all Rapid Responses

Pregnancy affects breast cancer survival

Ellen C G Grant
bmj.com, 15 Dec 2006 [Full text]

Authors' response

Angela Ives, et al.
bmj.com, 22 Dec 2006 [Full text]

Effects of subsequent pregnancy in patients with breast cancer need further evaluation.

Jeevan P Marasinghe, et al.
bmj.com, 9 Jan 2007 [Full text]

Regret of some women for denying themselves a pregnancy difficult to quantify

Ludger Barthelmes, et al.
bmj.com, 1 Feb 2007 [Full text]

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