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Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis

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Abstract
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PURPOSE Many patients and physicians remain concerned about the potential detrimental effects of pregnancy
after breast cancer (BC) in terms of reproductive outcomes and maternal safety. This systematic review and
meta-analysis aimed at providing updated evidence on these topics.
METHODS A systematic literature review was conducted to identify studies including patients with a pregnancy
after BC (PROSPERO number CRD42020158324). Likelihood of pregnancy after BC, their reproductive
outcomes, and maternal safety were assessed. Pooled relative risks, odds ratios (ORs), and hazard ratios (HRs)
with 95% CIs were calculated using random effects models.
RESULTS Of 6,462 identified records, 39 were included involving 8,093,401 women from the general population
and 112,840 patients with BC of whom 7,505 had a pregnancy after diagnosis. BC survivors were significantly
less likely to have a subsequent pregnancy compared with the general population (relative risk, 0.40; 95% CI,
0.32 to 0.49). Risks of caesarean section (OR, 1.14; 95% CI, 1.04 to 1.25), low birth weight (OR, 1.50; 95% CI,
1.31 to 1.73), preterm birth (OR, 1.45; 95% CI, 1.11 to 1.88), and small for gestational age (OR, 1.16; 95% CI,
1.01 to 1.33) were significantly higher in BC survivors, particularly in those with previous chemotherapy exposure, compared with the general population. No significantly increased risk of congenital abnormalities or
other reproductive complications were observed. Compared to patients with BC without subsequent
pregnancy, those with a pregnancy had better disease-free survival (HR, 0.66; 95% CI, 0.49 to 0.89) and overall
survival (HR, 0.56; 95% CI, 0.45 to 0.68). Similar results were observed after correcting for potential confounders and irrespective of patient, tumor, and treatment characteristics, pregnancy outcome, and timing of
pregnancy.
CONCLUSION These results provide reassuring evidence on the safety of conceiving in BC survivors. Patients’
pregnancy desire should be considered a crucial component of their survivorship care plan.
Author(s)
Eva BlondeauxMarco Bruzzone김희정Fedro A PeccatoriMatteo Lambertini
Issued Date
2021
Type
Article
Keyword
Breast Neoplasms - mortalityCancer SurvivorsFemaleHumansPregnancyPregnancy ComplicationsNeoplastic - mortalityPregnancy Outcome
DOI
10.1200/JCO.21.00535
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8190
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2548416546&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Pregnancy%20After%20Breast%20Cancer:%20A%20Systematic%20Review%20and%20Meta-Analysis&offset=0&pcAvailability=true
Publisher
JOURNAL OF CLINICAL ONCOLOGY
Location
미국
Language
한국어
ISSN
0732-183X
Citation Volume
2021
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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