Pregnancy after breast cancer: The importance of active counselling and planning

• Published in: Breast (Edinburgh) 2009-12, Vol.18 (6), p.345-350
• Main Authors: Rippy, E.E, Karat, I.F, Kissin, M.W
• Format: Article
• Language: English
• Subjects: Adult; Breast cancer; Breast Neoplasms - therapy; Counseling; Counselling; Family Planning Services; Female; Fertility; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Pregnancy; Pregnancy Complications, Neoplastic - therapy; Prognosis; Surveys and Questionnaires; Young Adult
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2009.08.003

Abstract Aim To investigate the effect of breast cancer, its treatment and counselling on future pregnancy and fertility. Method Three hundred and four women 45 years and younger at the time of diagnosis of breast cancer were identified from one breast unit from 1997 to 2006. A questionnaire was sent to all patients asking about pregnancy, counselling and fertility issues. Results Of 304 women, 248 were still alive and not lost to follow up. The questionnaire response rate was 66% and the average follow up was 60 months. By questionnaire response, 39 women had wanted children before diagnosis, and 24 still wanted them post treatment, giving a successful pregnancy rate of 75%. Eighteen patients have become pregnant, 4 with more than one pregnancy. 107 patients were specifically counselled about fertility prior to breast cancer treatment. The mortality due to breast cancer was 10% in non-pregnant patients and 6% in patients who became pregnant after breast cancer. Conclusion Pregnancy after breast cancer does not confer a poor prognosis. A higher rate of pregnancy than expected was found after treatment, possibly due to newer treatments including fertility preservation and also possibly due to the active counselling programme in this unit. Patients should have active counselling about fertility when planning treatment and fertility conservation can then be incorporated into a treatment plan.