Conception and pregnancy among women with a live birth after breast cancer treatment: A survey study of young breast cancer survivors

BackgroundBreast cancer (BC) is the most common malignancy in women of reproductive age. This study sought to explore the postcancer conception and pregnancy experience of young BC survivors to inform counseling.MethodsIn the Young Women's Breast Cancer Study (NCT01468246), a multicenter, prospective cohort, participants diagnosed at age <= 40 years with stage 0-III BC who reported >= 1 postdiagnosis live birth were sent an investigator-developed survey.ResultsOf 119 eligible women, 94 (79%) completed the survey. Median age at diagnosis was 32 years (range, 17-40) and at first postdiagnosis delivery was 38 years (range, 29-47). Most had stage I or II (77%) and HR+ (78%) BC; 51% were nulligravida at diagnosis. After BC treatment, most (62%) conceived naturally, though 38% used assisted reproductive technology, 74% of whom first attempted natural conception for a median of 9 months (range, 2-48). Among women with a known inherited pathogenic variant (n = 20), two underwent preimplantation genetic testing. Of 59 women on endocrine therapy before pregnancy, 26% did not resume treatment. Hypertensive disorders of pregnancy (20%) was the most common obstetrical condition. Nine percent of newborns required neonatal intensive care unit admission and 9% had low birth weight.ConclusionAmong women with live births after BC treatment, most conceived naturally and having a history of BC did not appear to negatively impact pregnancy complications, though the high rate of hypertensive disorders of pregnancy warrants further investigation. The prolonged period of attempting natural conception for some survivors suggests the potential need for improved understanding and counseling surrounding family planning goals after BC. In a cohort of 94 women surveyed with one or more live birth(s) after breast cancer treatment, although most conceived naturally, observations suggest potential gaps in counseling related to use of artificial reproductive technology and future childbearing when planning endocrine therapy. History of breast cancer did not appear to negatively impact pregnancy complications, though a higher rate of hypertensive disorders of pregnancy was observed compared with prior studies of breast cancer survivors, requiring further investigation.