J Alejandro Rauh-Hain1,2, Jose Zubizarreta3,4, Roni Nitecki1, Alexander Melamed5, Shuangshuang Fu2, Kirsten Jorgensen1, Paula C Brady6, Valerie L Baker7, Mariana Chavez-MacGregor2,8, Sharon H Giordano2,8, Nancy L Keating3,9. 1. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 2. Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 3. Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA. 4. Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA. 5. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA. 6. Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA. 7. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland, USA. 8. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 9. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Abstract
BACKGROUND: This study sought to determine the impact of pregnancy or assisted reproductive technologies (ART) on breast-cancer-specific survival among breast cancer survivors. METHODS: The authors performed a cohort study using a novel data linkage from the California Cancer Registry, the California birth cohort, and the Society for Assisted Reproductive Technology Clinic Outcome Reporting System data sets. They performed risk-set matching in women with stages I-III breast cancer diagnosed between 2000 and 2012. For each pregnant woman, comparable women who were not pregnant at that point but were otherwise similar based on observed characteristics were matched at the time of pregnancy. After matching, Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of pregnancy with breast-cancer-specific survival. We repeated these analyses for women who received ART. RESULTS: Among 30,021 women with breast cancer, 553 had a pregnancy and 189 attempted at least one cycle of ART. In Cox proportional hazards modeling, the pregnancy group had a higher 5-year disease-specific survival rate; 95.6% in the pregnancy group and 90.6% in the nonpregnant group (HR, 0.43; 95% CI, 0.24-0.77). In women with hormone receptor-positive cancer, we found similar results (HR, 0.43; 95% CI, 0.2-0.91). In the ART analysis, there was no difference in survival between groups; the 5-year disease-specific survival rate was 96.9% in the ART group and 94.1% in the non-ART group (HR, 0.44; 95% CI, 0.17-1.13). CONCLUSION: Pregnancy and ART are not associated with worse survival in women with breast cancer. LAY SUMMARY: We sought to determine the impact of pregnancy or assisted reproductive technologies (ART) among breast cancer survivors. We performed a study of 30,021 women by linking available data from California and the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. For each pregnant woman, we matched at the time of pregnancy comparable women who were not pregnant at that point but were otherwise similar based on observed characteristics. We repeated these analyses for women who received ART. We found that pregnancy and ART were not associated with worse survival.
BACKGROUND: This study sought to determine the impact of pregnancy or assisted reproductive technologies (ART) on breast-cancer-specific survival among breast cancer survivors. METHODS: The authors performed a cohort study using a novel data linkage from the California Cancer Registry, the California birth cohort, and the Society for Assisted Reproductive Technology Clinic Outcome Reporting System data sets. They performed risk-set matching in women with stages I-III breast cancer diagnosed between 2000 and 2012. For each pregnant woman, comparable women who were not pregnant at that point but were otherwise similar based on observed characteristics were matched at the time of pregnancy. After matching, Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of pregnancy with breast-cancer-specific survival. We repeated these analyses for women who received ART. RESULTS: Among 30,021 women with breast cancer, 553 had a pregnancy and 189 attempted at least one cycle of ART. In Cox proportional hazards modeling, the pregnancy group had a higher 5-year disease-specific survival rate; 95.6% in the pregnancy group and 90.6% in the nonpregnant group (HR, 0.43; 95% CI, 0.24-0.77). In women with hormone receptor-positive cancer, we found similar results (HR, 0.43; 95% CI, 0.2-0.91). In the ART analysis, there was no difference in survival between groups; the 5-year disease-specific survival rate was 96.9% in the ART group and 94.1% in the non-ART group (HR, 0.44; 95% CI, 0.17-1.13). CONCLUSION: Pregnancy and ART are not associated with worse survival in women with breast cancer. LAY SUMMARY: We sought to determine the impact of pregnancy or assisted reproductive technologies (ART) among breast cancer survivors. We performed a study of 30,021 women by linking available data from California and the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. For each pregnant woman, we matched at the time of pregnancy comparable women who were not pregnant at that point but were otherwise similar based on observed characteristics. We repeated these analyses for women who received ART. We found that pregnancy and ART were not associated with worse survival.
Authors: Aladdin H Shadyab; Margery L S Gass; Marcia L Stefanick; Molly E Waring; Caroline A Macera; Linda C Gallo; Richard A Shaffer; Sonia Jain; Andrea Z LaCroix Journal: Am J Public Health Date: 2016-11-17 Impact factor: 9.308
Authors: Matteo Lambertini; Lieveke Ameye; Anne-Sophie Hamy; Anna Zingarello; Philip D Poorvu; Estela Carrasco; Albert Grinshpun; Sileny Han; Christine Rousset-Jablonski; Alberta Ferrari; Shani Paluch-Shimon; Laura Cortesi; Claire Senechal; Gianmaria Miolo; Katarzyna Pogoda; Jose Alejandro Pérez-Fidalgo; Laura De Marchis; Riccardo Ponzone; Luca Livraghi; Maria Del Pilar Estevez-Diz; Cynthia Villarreal-Garza; Maria Vittoria Dieci; Florian Clatot; Martine Berlière; Rossella Graffeo; Luis Teixeira; Octavi Córdoba; Amir Sonnenblick; Helena Luna Pais; Michail Ignatiadis; Marianne Paesmans; Ann H Partridge; Olivier Caron; Claire Saule; Lucia Del Mastro; Fedro A Peccatori; Hatem A Azim Journal: J Clin Oncol Date: 2020-07-16 Impact factor: 44.544