The Influence Of Post-treatment Pregnancy To Young Breast Cancer Patients

Objective:To understand the status of pregnancy after breast cancer treatment and evaluate the effects of pregnancy subsequent to treatment on disease progression and survival in breast cancer patients.Methods:Medical records review of176breast cancer patients age<35years in Tianjin Medical University Cancer Hospital between January2003and December2007. The median follow-up period was74months. This study involved176patients was conducted to compare prognosis among breast cancer patients with and without a subsequent pregnancy. The pregnancy status, clinical and pathological characteristics were included and analyzed by statistical software SPSS19.0to 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 such experience, with p<0.05defined as a statistically significant difference.Results:In all,35patients were pregnant after breast cancer treatment, in which7women experienced full term births and28abortions. Patients who experienced a pregnancy tended to be younger (age<30,65.7%vs.14.2%). The2and5years disease-free survival were97.1%、94.2%for women experienced pregnancy and90.8%、75.7%for women who did not (p=0.05). The5years overall survival was100%for women experienced pregnancy and90.6%for women who did not (p=0.08). Univariate factor analysis results showed that the tumor size, ER, HER-2, nodal status were related with disease free survival (p<0.05), the above were also significantly related with overall survival. Multivariate factors analysis result indicated that tumor size was independent factors of disease free survival, which also appeared to be the only independent factor of overall survival. Cox regression showed that pregnancy after breast cancer treatment implied significant protective effect on disease progression (HR=0.221,95%CI0.06～0.81,p=0.022) compared with women who did not, however, it had no significant positive impact on overall survival (HR=0.000, p=0.965)Conclusions:The current study indicated that pregnancy was associated with a decreased risk of disease progression; we found no evidence that a pregnancy after treatment of breast cancer has a negative influence the prognosis.