Patterns of Fertility Preservation and Pregnancy Outcome After Breast Cancer at a Large Comprehensive Cancer Center

Maria Vittoria Dieci, Cristina Ghiotto, Caterina Barbieri, Gaia Griguolo, Carlo Saccardi, Michele Gangemi, Alfonso Pluchinotta, Elisabetta Di Liso, Carlo Alberto Giorgi, Tommaso Giarratano, Giulia Tasca, Grazia Vernaci, Giovanni Faggioni, Pierfranco Conte, Valentina Guarneri

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Abstract

BACKGROUND: In the last decades, long-term outcomes of breast cancer (BC) patients have improved, raising new survivorship issues, including fertility preservation and safety of pregnancy after BC. This study assesses evolution in patterns of fertility discussion/preservation over time and reports pregnancy outcomes in a cohort of young BC patients.

METHODS: A retrospective cohort of 590 BC patients aged ≤40 diagnosed between 2000 and 2016 at a large cancer center was identified. Fertility counseling and preservation patterns for patients receiving chemotherapy were analyzed and compared for two cohorts: 2004-2006 and 2014-2016 (total n = 161). Outcomes were reported for patients with documented pregnancy after BC.

RESULTS: Significantly, more patients diagnosed in 2014-2016 had evidence of discussion on fertility issues and/or application of fertility preservation techniques versus patients diagnosed in 2004-2006 (82.9% vs. 66.0%, p = 0.017). In particular, there was a significant difference in rate of documented fertility issues discussion (67.6% vs. 34.0%, p < 0.001). Age >35 and parity were associated with lower rates of fertility discussion/preservation. However, rates significantly improved over time (77.6% in 2014-2016 vs. 58.1% in 2004-2006 for patients aged >35, p = 0.046; 80.7% in 2014-2016 vs. 57.6% in 2004-2006 for patients with children at diagnosis, p = 0.018). Twenty-six patients with pregnancy after BC were identified; eight delivered at the age of >40. No complications for women or newborns were reported. Only two patients experienced BC relapse.

CONCLUSIONS: In this small retrospective cohort, no safety concerns were identified for pregnancy after BC. The importance attributed by clinicians to address fertility issues has increased over time.

Original languageEnglish
JournalJournal of Women's Health
DOIs
Publication statusE-pub ahead of print - Jul 2 2018

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Fertility Preservation
Pregnancy Outcome
Breast Neoplasms
Neoplasms
Pregnancy
Fertility
Safety
Birth Rate
Parity
Counseling
Survival Rate
Newborn Infant

Cite this

@article{10df64f072fb47849411122f3c45900f,
title = "Patterns of Fertility Preservation and Pregnancy Outcome After Breast Cancer at a Large Comprehensive Cancer Center",
abstract = "BACKGROUND: In the last decades, long-term outcomes of breast cancer (BC) patients have improved, raising new survivorship issues, including fertility preservation and safety of pregnancy after BC. This study assesses evolution in patterns of fertility discussion/preservation over time and reports pregnancy outcomes in a cohort of young BC patients.METHODS: A retrospective cohort of 590 BC patients aged ≤40 diagnosed between 2000 and 2016 at a large cancer center was identified. Fertility counseling and preservation patterns for patients receiving chemotherapy were analyzed and compared for two cohorts: 2004-2006 and 2014-2016 (total n = 161). Outcomes were reported for patients with documented pregnancy after BC.RESULTS: Significantly, more patients diagnosed in 2014-2016 had evidence of discussion on fertility issues and/or application of fertility preservation techniques versus patients diagnosed in 2004-2006 (82.9{\%} vs. 66.0{\%}, p = 0.017). In particular, there was a significant difference in rate of documented fertility issues discussion (67.6{\%} vs. 34.0{\%}, p < 0.001). Age >35 and parity were associated with lower rates of fertility discussion/preservation. However, rates significantly improved over time (77.6{\%} in 2014-2016 vs. 58.1{\%} in 2004-2006 for patients aged >35, p = 0.046; 80.7{\%} in 2014-2016 vs. 57.6{\%} in 2004-2006 for patients with children at diagnosis, p = 0.018). Twenty-six patients with pregnancy after BC were identified; eight delivered at the age of >40. No complications for women or newborns were reported. Only two patients experienced BC relapse.CONCLUSIONS: In this small retrospective cohort, no safety concerns were identified for pregnancy after BC. The importance attributed by clinicians to address fertility issues has increased over time.",
author = "Dieci, {Maria Vittoria} and Cristina Ghiotto and Caterina Barbieri and Gaia Griguolo and Carlo Saccardi and Michele Gangemi and Alfonso Pluchinotta and {Di Liso}, Elisabetta and Giorgi, {Carlo Alberto} and Tommaso Giarratano and Giulia Tasca and Grazia Vernaci and Giovanni Faggioni and Pierfranco Conte and Valentina Guarneri",
year = "2018",
month = "7",
day = "2",
doi = "10.1089/jwh.2018.6986",
language = "English",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",

}

TY - JOUR

T1 - Patterns of Fertility Preservation and Pregnancy Outcome After Breast Cancer at a Large Comprehensive Cancer Center

AU - Dieci, Maria Vittoria

AU - Ghiotto, Cristina

AU - Barbieri, Caterina

AU - Griguolo, Gaia

AU - Saccardi, Carlo

AU - Gangemi, Michele

AU - Pluchinotta, Alfonso

AU - Di Liso, Elisabetta

AU - Giorgi, Carlo Alberto

AU - Giarratano, Tommaso

AU - Tasca, Giulia

AU - Vernaci, Grazia

AU - Faggioni, Giovanni

AU - Conte, Pierfranco

AU - Guarneri, Valentina

PY - 2018/7/2

Y1 - 2018/7/2

N2 - BACKGROUND: In the last decades, long-term outcomes of breast cancer (BC) patients have improved, raising new survivorship issues, including fertility preservation and safety of pregnancy after BC. This study assesses evolution in patterns of fertility discussion/preservation over time and reports pregnancy outcomes in a cohort of young BC patients.METHODS: A retrospective cohort of 590 BC patients aged ≤40 diagnosed between 2000 and 2016 at a large cancer center was identified. Fertility counseling and preservation patterns for patients receiving chemotherapy were analyzed and compared for two cohorts: 2004-2006 and 2014-2016 (total n = 161). Outcomes were reported for patients with documented pregnancy after BC.RESULTS: Significantly, more patients diagnosed in 2014-2016 had evidence of discussion on fertility issues and/or application of fertility preservation techniques versus patients diagnosed in 2004-2006 (82.9% vs. 66.0%, p = 0.017). In particular, there was a significant difference in rate of documented fertility issues discussion (67.6% vs. 34.0%, p < 0.001). Age >35 and parity were associated with lower rates of fertility discussion/preservation. However, rates significantly improved over time (77.6% in 2014-2016 vs. 58.1% in 2004-2006 for patients aged >35, p = 0.046; 80.7% in 2014-2016 vs. 57.6% in 2004-2006 for patients with children at diagnosis, p = 0.018). Twenty-six patients with pregnancy after BC were identified; eight delivered at the age of >40. No complications for women or newborns were reported. Only two patients experienced BC relapse.CONCLUSIONS: In this small retrospective cohort, no safety concerns were identified for pregnancy after BC. The importance attributed by clinicians to address fertility issues has increased over time.

AB - BACKGROUND: In the last decades, long-term outcomes of breast cancer (BC) patients have improved, raising new survivorship issues, including fertility preservation and safety of pregnancy after BC. This study assesses evolution in patterns of fertility discussion/preservation over time and reports pregnancy outcomes in a cohort of young BC patients.METHODS: A retrospective cohort of 590 BC patients aged ≤40 diagnosed between 2000 and 2016 at a large cancer center was identified. Fertility counseling and preservation patterns for patients receiving chemotherapy were analyzed and compared for two cohorts: 2004-2006 and 2014-2016 (total n = 161). Outcomes were reported for patients with documented pregnancy after BC.RESULTS: Significantly, more patients diagnosed in 2014-2016 had evidence of discussion on fertility issues and/or application of fertility preservation techniques versus patients diagnosed in 2004-2006 (82.9% vs. 66.0%, p = 0.017). In particular, there was a significant difference in rate of documented fertility issues discussion (67.6% vs. 34.0%, p < 0.001). Age >35 and parity were associated with lower rates of fertility discussion/preservation. However, rates significantly improved over time (77.6% in 2014-2016 vs. 58.1% in 2004-2006 for patients aged >35, p = 0.046; 80.7% in 2014-2016 vs. 57.6% in 2004-2006 for patients with children at diagnosis, p = 0.018). Twenty-six patients with pregnancy after BC were identified; eight delivered at the age of >40. No complications for women or newborns were reported. Only two patients experienced BC relapse.CONCLUSIONS: In this small retrospective cohort, no safety concerns were identified for pregnancy after BC. The importance attributed by clinicians to address fertility issues has increased over time.

U2 - 10.1089/jwh.2018.6986

DO - 10.1089/jwh.2018.6986

M3 - Article

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

ER -