The prognosis of patients who become pregnant after mastectomy for breast cancer.

Forty-seven patients were treated for primary operable carcinoma of the breast and had subsequent pregnancies. Their ages varied from 22-45 years, the median age being 35 years. Each patient with negative nodes received only a radical mastectomy, and each patient who had metastases to the lymph nodes in addition received a course of radiation therapy. None of the patients received chemotherapy. Of the 30 patients who did not have metastases to the lymph nodes, 23 survived a 10-year period (77%). Of the 16 patients who manifested metastases to the lymph nodes, nine survived a 10-year period (56%). No detrimental effect of subsequent pregnancy could be demonstrated even among patients with positive axillary nodes. It is generally agreed that most metastases show up within a 3-year period before incurring a pregnancy. In this series there was no differences between those who delayed. Abortion could not be demonstrated to improve the survival rate; in fact, patients who had abortions did worse than those who did not. We conclude, accordingly, that pregnancy need not be avoided or terminated among those patients who are apparently free of recurrences or residual cancer after undergoing treatment for carcinoma of the breast. The decision to become pregnant and the medical conduct of the pregnant female are best determined by the stage of the cancer and how the malignant potential affects prognosis. Careful consultation should be sought with all support personnel, which should include the husband, spiritual leader, psychologist, etc., to discuss the potential for the patient's surviving and supporting the child.(ABSTRACT TRUNCATED AT 250 WORDS)