Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts.
Cancer. 2021 Apr 1;127(7):1021-1028. doi: 10.1002/cncr.33342. Epub 2020 Dec 1.
Many young women with newly diagnosed breast cancer are interested in future pregnancies. Prospective data regarding fertility interest and reproductive patterns after diagnosis are needed to counsel patients.
The Young Women's Breast Cancer Study is a multicenter, prospective cohort of women who were diagnosed with breast cancer at age ≤40 years between 2006 and 2016. Women complete surveys at baseline, every 6 months for 3 years, then annually. Here, the authors describe fertility interest and pregnancies within 5 years of diagnosis for women with stage 0 through III breast cancer.
Of 1026 eligible participants, 368 (36%) reported interest in future biologic children at least once within 5 years after diagnosis, including 16% at 5 years after diagnosis. Among 130 women who attempted to become pregnant, 90 (69.2%) conceived; and, among 896 women who did not attempt to conceive, 18 (2.0%) became pregnant, with a total of 152 pregnancies resulting in 91 live births. Factors associated with pregnancy included younger versus older age at diagnosis (aged ≤30 vs 36-40 years: odds ratio [OR], 6.63; 95% CI, 3.18-13.83; P < .0001; aged 31-35 vs 36-40 years: OR, 5.86; 95% CI, 3.37-10.17; P < .0001) and being nulliparous versus parous (OR, 2.66; 95% CI, 1.56-4.53; P = .001). The receipt of endocrine therapy versus no endocrine therapy (OR, 0.35; 95% CI, 0.20-0.59; P = .001) was inversely associated with pregnancy.
Many women remain interested in future fertility in the 4 years after a breast cancer diagnosis, indicating that longitudinal fertility discussions are needed. Although a minority of those interested in having children attempted to become pregnant in the first 5 years, most who attempted to conceive did so and had live births.
许多新诊断为乳腺癌的年轻女性对未来的怀孕感兴趣。为了给患者提供咨询，需要有关于生育意愿和诊断后生殖模式的前瞻性数据。
年轻女性乳腺癌研究是一项多中心、前瞻性队列研究，纳入了 2006 年至 2016 年间年龄≤40 岁确诊为乳腺癌的女性。女性在基线时、前 3 年每 6 个月、之后每年完成一次调查。在此，作者描述了 0 期至 III 期乳腺癌女性在诊断后 5 年内的生育意愿和妊娠情况。
在 1026 名符合条件的参与者中，368 名（36%）在诊断后 5 年内至少有一次表示有生育生物学后代的意愿，包括 16%在诊断后 5 年。在 130 名试图怀孕的女性中，90 名（69.2%）怀孕；而在 896 名未尝试怀孕的女性中，18 名（2.0%）怀孕，共有 152 名怀孕，91 名活产。与怀孕相关的因素包括年龄较小（≤30 岁与 36-40 岁：比值比[OR]，6.63；95%置信区间[CI]，3.18-13.83；P<0.0001；31-35 岁与 36-40 岁：OR，5.86；95%CI，3.37-10.17；P<0.0001）和未生育（OR，2.66；95%CI，1.56-4.53；P=0.001）。与未接受内分泌治疗（OR，0.35；95%CI，0.20-0.59；P=0.001）相比，接受内分泌治疗与怀孕呈负相关。
许多女性在乳腺癌诊断后的 4 年内仍然对未来的生育能力感兴趣，这表明需要进行纵向生育讨论。虽然有生育意愿的少数人在最初的 5 年内尝试怀孕，但大多数尝试怀孕的人都成功并分娩。
