Wednesday, April 19, 2023

Pregnancy after breast cancer.. Protective effect of pregnancy in non-hormonal dependent breast cancer

breast cancer:

With a later age at first pregnancy, breast cancer strikes many women each year before they have had time to decide to have a baby. Because prolonged pregnancy has been viewed as increasing the risk of relapse, few of them become pregnant after treatment. In 2017, a study presented at the American Congress of Oncology showed that this is not the case.

Breast cancer is the most common type of cancer in women of childbearing age, and while nearly half of young women diagnosed with breast cancer admit to wanting a baby, less than 10% become pregnant after treatment. Of all cancer survivors, breast cancer survivors are the least likely to have a baby after diagnosis.

Mostly aborted pregnancies after breast cancer:

This is caused by doctors and patients who have long believed that pregnancy may increase the risk of breast cancer recurrence, especially in women with hormone-dependent (ER+) tumors. Knowing that this type of cancer sees an increase in its growth due to estrogen, pregnancy and its levels High levels of the hormone have long been suspected of promoting the growth of occult cancer cells (those that remain after treatment) and thus their recurrence.

Another medical concern is the need to stop adjuvant hormone therapy (after surgery) before pregnancy occurs. This adjuvant hormonal therapy helps prevent cancer recurrence and is recommended for women for a minimum of 5 years and in some cases up to 10 years according to studies presented at the ASCO conference. the previous.

No more recurrence or death after pregnancy:

Presented at the ASCO 2017 conference, results of a retrospective study of 1,200 women provided reassurance to women with breast cancer who are considering pregnancy. Women who became pregnant after being diagnosed with early breast cancer, including hormone-dependent cancers, had no greater risk of recurrence and death from the cancer than non-pregnant women.

Protective effect of pregnancy in non-hormone-dependent breast cancer?

Pregnant women after estrogen-insensitive (ER-negative) breast cancer had a decreased risk of death. Pregnancy may be a protective factor for patients with ER-negative breast cancer, either through immune-related or hormonal mechanisms, but we need further research into this field. Although there is a small amount of breastfeeding data from this study (64 patients, 25 of whom reported breastfeeding their newborns), the results indicate that breastfeeding is possible even after breast surgery.

PMA, BRCA, hormonal therapy... Some points still need clarification:

Although it is the largest study on the subject, this study had limited information on the use of assisted reproductive technologies (such as IVF) in these women, or on the HER2 tumor status, unknown to about 80% of the women. More research is also needed to assess the impact of pregnancy on the health of women with BRCA mutations, cancers that often occur at younger ages.