Labrosse Julie, Lecourt Anne, Hours Alice, Sebbag Clara, Toussaint Aullene, Laas Enora, Coussy Florence, Grandal Beatriz, Dumas Elise, Daoud Eric, Morel Charlotte, Feron Jean-Guillaume, Faron Matthieu, Pierga Jean-Yves, Reyal Fabien, Hamy Anne-Sophie
Department of Surgery, Institut Curie, 75005 Paris, France.
Centre René Hughenin, Medical Oncology Department, 92210 Saint Cloud, France.
Cancers (Basel). 2021 Mar 3;13(5):1070. doi: 10.3390/cancers13051070.
Although an increasing number of young breast cancer (BC) patients have a pregnancy desire after BC, the time necessary to obtain a pregnancy after treatment and subsequent outcomes remain unknown. We aimed to determine the time to evolutive pregnancy in a cohort of BC survivors and subsequent obstetrical and neonatal outcomes. We analyzed BC patients treated at Institut Curie from 2005-2017, aged 18-43 years old (y.o.) at diagnosis having at least one subsequent pregnancy. 133 patients were included, representing 197 pregnancies. Mean age at BC diagnosis was 32.8 y.o. and at pregnancy beginning was 36.8 y.o. 71% pregnancies were planned, 18% unplanned and 86% spontaneous. 64% pregnancies resulted in live birth ( = 131). Median time from BC diagnosis to pregnancy beginning was 48 months and was significantly associated with endocrine therapy ( < 0.001). Median time to pregnancy was 4.3 months. Median time to evolutive pregnancy 5.6 months. In multivariate analysis, menstrual cycles before pregnancy remained significantly associated with time to pregnancy and endocrine therapy with time evolutive to pregnancy. None of the BC treatments (chemotherapy/endocrine therapy/trastuzumab) was significantly associated with obstetrical nor neonatal outcomes, that seemed comparable to global population. Our findings provide reassuring data for pregnancy counseling both in terms of delay and outcome.
尽管越来越多的年轻乳腺癌患者在患癌后有怀孕的意愿，但治疗后怀孕所需的时间以及后续结果仍不明确。我们旨在确定一组乳腺癌幸存者实现妊娠进展的时间以及随后的产科和新生儿结局。我们分析了2005年至2017年在居里研究所接受治疗的乳腺癌患者，这些患者诊断时年龄在18至43岁之间，且至少有一次后续妊娠。纳入了133名患者，共197次妊娠。乳腺癌诊断时的平均年龄为32.8岁，怀孕开始时的平均年龄为36.8岁。71%的妊娠是计划内的，18%是意外妊娠，86%是自然妊娠。64%的妊娠分娩活婴（n = 131）。从乳腺癌诊断到怀孕开始的中位时间为48个月，且与内分泌治疗显著相关（P < 0.001）。怀孕的中位时间为4.3个月。妊娠进展的中位时间为5.6个月。在多变量分析中，怀孕前的月经周期仍与怀孕时间显著相关，内分泌治疗与妊娠进展时间显著相关。乳腺癌的任何治疗（化疗/内分泌治疗/曲妥珠单抗）均与产科或新生儿结局无显著关联，这些结局似乎与总体人群相当。我们的研究结果在延迟和结局方面为妊娠咨询提供了令人安心的数据。
