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Risk of recurrence and pregnancy outcomes in young women with breast cancer who do and do not undergo fertility preservation

  • Epidemiology
  • Published:
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Abstract

Purpose

To assess the impact of fertility preservation (FP) requiring ovarian stimulation on breast cancer outcomes and pregnancy after breast cancer.

Methods

Women aged ≤ 40 years diagnosed with stage I–III breast cancer between 2007 and 2018 and referred for FP consultation prior to systemic therapy were identified from a British Columbia fertility center database. The primary endpoint was invasive breast cancer-free survival (iBCFS) and secondary endpoints were overall survival (OS) and achievement of pregnancy. Survival and pregnancy endpoints were compared using Cox and logistic regression analyses, respectively, for patients who did and did not undergo FP.

Results

The study included 153 patients, with 71 (46%) in the FP group and 82 (54%) in the non-FP group. Patients who underwent FP were more likely to be ECOG 0 (99% vs. 88%, p = 0.011) and receive chemotherapy (93% vs. 67%, p < 0.001), but had similar ER positivity status to non-FP patients (70% vs. 79%, p = 0.21). Over a median follow-up of 4.1 years, there were no differences in iBCFS (HR 1.006, 95% CI 0.416–2.438, p = 0.988) or OS (HR 0.789, 95% CI 0.210–2.956, p = 0.725) between FP and non-FP groups. Patients who underwent FP had higher odds of conceiving at least once (OR 3.024, 95% CI 1.312–6.970, p = 0.008).

Conclusion

At a median follow-up of 4.1 years, FP did not impact iBCFS or OS, supporting its safety in young women with breast cancer. In addition, patients who underwent FP were more likely to become pregnant after breast cancer, highlighting the value of pre-oncologic treatment FP in survivorship family planning.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Ying Wang and Megan E. Tesch have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada

    Ying Wang, Megan E. Tesch & Caroline A. Lohrisch

  2. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Chloe Lim

  3. Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

    Ying Hui Xu

  4. Division of Oncology and Department of Gynecology, Allan Blair Cancer Centre, Regina, SK, Canada

    Shaina Lee

  5. William Osler Health System, Brampton, ON, Canada

    Kirstin Perdizet

  6. Trillium Health Partners, Credit Valley Hospital, Mississauga, ON, Canada

    Dan Yokom

  7. Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada

    Ellen Warner

  8. Pacific Centre for Reproductive Medicine, Vancouver, BC, Canada

    Jeffery Roberts

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  1. Ying Wang
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Contributions

All authors contributed to the study conception and design. Data collection was performed by YW, MT, CL, YHX, and SL. Data analysis was performed by YW and MT. The first draft of the manuscript was written by MT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Caroline A. Lohrisch.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the University of British Columbia Research BC Cancer Research Ethics Board (No. H14-03334).

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Wang, Y., Tesch, M.E., Lim, C. et al. Risk of recurrence and pregnancy outcomes in young women with breast cancer who do and do not undergo fertility preservation. Breast Cancer Res Treat 195, 201–208 (2022). https://doi.org/10.1007/s10549-022-06650-z

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  • DOI: https://doi.org/10.1007/s10549-022-06650-z

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