Aim:To understand the status of pregnancy after breast cancer treatment and evaluate its effects on disease progression and survival in breast cancer patients.
Methods:This study involved 176 patients,which was conducted to compare prognosis among breast cancer patients with or without a subsequent pregnancy in Tianjin Cancer Hospital between January 2003 and December 2007.The median follow-up period was 74 months. The pregnancy status, clinical and pathological characteristics were included and analyzed by statistical software SPSS19.0 to calculate the relation with disease-free survival and overall survival. The clinical data were described by the percentage, Kaplan-Meier method for calculation of survival, Log-Rank method for the univariate factor analysis, COX model for multivariate factors analysis, and COX regression was used to estimate the hazard ratio of dying among women with a pregnancy after breast cancer treatment compared with women without, with p<0.05 defined as a statistically significant difference.
Results:In all, 35 patients were pregnant after breast cancer treatment, in which 7 women experienced full term births and 28 abortions.The 5 years overall survival was 100% for women experienced pregnancy and 90.6% for women who did not (p=0.08). Univariate factor analysis results showed that the tumor size, ER, HER-2, nodal status and surgery method were related with disease free survival (p < 0.05), except the surgery method, the rest above were also significantly related with overall survival. Multivariate factors analysis result indicated that tumor size and surgery method were independent factors of disease free survival,and tumor size appeared to be the only independent factor of overall survival.Pregnancy after breast cancer treatment implied significant protective effect on disease progression （HR=0.22 p=0.02）compared with women who did not,however,it had no significant positive impact on overall survival（p=0.96).
Conclusions:There is no evidence that a pregnancy after treatment of breast cancer has a negative influence the prognosis.