The effect of pregnancy on survival in women with a history of breast cancer

Nearly 25% of individuals diagnosed with breast cancer will be pre-menopausal women. As maternal age of first birth has risen in the United States, more females are being treated for breast cancer prior to child-bearing. Although surgery and radiation therapy appear to have no impact on future fertility, young women should be aware of the impact that systemic chemotherapy may have on ovarian function, as well as on future offspring. As regards survival, despite a link between female sex hormones and mammary carcinogenesis, the fear that pregnancy subsequent to breast cancer treatment would result in activation of dormant micrometastases has not been demonstrated in the literature. Published series have, in fact, shown either no impact on survival or a slightly protective effect when women deliver after breast cancer treatment. Although these studies are retrospective in nature and may be prone to selection bias and under-reporting of the true denominator, they can at a minimum be used to reassure women that a subsequent pregnancy is unlikely to have a negative impact on her survival.