Effects of pregnancy after treatment for breast carcinoma on survival and risk of recurrence.
BACKGROUND
The goal of the current study was to assess the effect of pregnancy on the subsequent risk of recurrence after treatment for breast carcinoma, adjusting for established prognostic factors.


METHODS
Between 1974 and 1998, 383 patients age < or =35 years were treated for breast carcinoma with adjuvant chemotherapy at The University of Texas M. D. Anderson Cancer Center (Houston, TX). The median follow-up period was 13 years. Of these, 13 patients were excluded from analysis, as no history was available regarding pregnancy; 240 (65%) were >30 years old; 47 (13%) had at least 1 pregnancy after therapy; 32 had full-term pregnancies; 10 had spontaneous or elective abortions; 4 had miscarriages; and 1 had a premature delivery. Estrogen receptor (ER) status, lymph node involvement, and disease stage were evaluated as potential risk factors for recurrence. Information on ER status was unavailable for 123 (33%) patients.


RESULTS
Patients who experienced a pregnancy tended to have earlier-stage disease (Stage I/II: 80% vs. 73%), fewer positive lymph nodes (<4: 87% vs. 52%), more ER negativity (68% vs. 58%), and younger age (<30 years: 57% vs. 32%) than patients who did not. The incidence of disease recurrence was 23% for women who experienced a pregnancy and 54% for women who did not. The hazard ratio (using the multivariate Cox proportional hazards model) for disease recurrence in patients with posttreatment pregnancy was 0.71 (P=0.4).


CONCLUSIONS
In the current study population, pregnancy was not associated with an increased risk of disease recurrence or poorer survival in patients previously treated for breast carcinoma.
Blakely
L Johnetta
LJ
Division of Cancer Medicine, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA.
Buzdar
Aman U
AU
Lozada
Jose A
JA
Shullaih
Samer A
SA
Hoy
Emma
E
Smith
Terry L
TL
Hortobagyi
Gabriel N
GN
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D015412:Mastectomy, Segmental / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology* / Q000473:pathology; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis