| Background: Breast cancer(BC) is one of the most common malignant tumor in the reproductive age women. The incidence of breast cancer in our country is growing fast now. The age at diagnosis is gradually younger. Due to the trend of postponing childbearing to a later reproductive age, development of treatment, and the changed childbearing policy in China, an increasing number of women are expected to conceive after effective treatment for breast cancer. The safety of pregnancy following BC has become a hot focus. And there is considerable controversy regarding the long term prognosis for breast cancer patients who become pregnant after the treatment. Objective: To perform a systematic review of correlational studies which assess the prognosis of the disease with post-treatment pregnancy, and assess the safety of pregnancy after breast cancer.Methods: To perform a systematic and statistical review of correlational studies which assess the prognosis of the disease with post-treatment pregnancy, The literature up to July 2014 was searched using the MEDLINE(Pub Med), OVID, Google Scholar, China National Knowledge Infrastructure(CNKI) databases and Wan Fang database. And cited reference retrieval and manual literature retrieval were used. Abstracts were reviewed to identify reports examining associations between pregnancy after breast cancer and the patient’s cancer prognosis. The investigators selected and excluded all articles according to the strict criteria. The authors assessed the heterogeneity in this Meta-analysis by subgroup analyses. Random effects meta-analysis and RR were used to estimate the association between pregnancy after breast cancer and survival. Heterogeneity was assessed using the P-values. Subgroup analyses based on the type of estimate, follow-up duration, mean age at diagnosis, country of origin, interval between breast cancer diagnosis and pregnancy, year of publication, outcome of pregnancy, and the type of study design were conducted to identify the risk-subgroup interactions that couldexplain the inter-study differences. Publication bias was assessed using the Funnel Spot. Software Review Manager 5.0 was used for the statistical analyses. All the P-values were two tailed, and P-values <0.05 were considered statistically significant.Results: Nineteen studies were included in this meta-analysis that included 2,356 cases and 28,935 controls. The patients who conceived subsequent to the diagnosis of breast cancer had a significantly lower risk of death compared to those who did not become pregnant(p RR: 0.61; 95% CI 0.48-0.73; P<0.001). In a subgroup analysis, the type of estimate comparing crude vs. adjusted(p RR 0.53 vs. 0.62, P=0.219) and the year of publication before 2000 vs. after 2000(p RR 0.57 vs. 0.54, P=0.598) were not major sources of heterogeneity. We did find significant differences in survival between the groups in the follow-up duration, mean age at diagnosis, country of origin, interval between breast cancer diagnosis and pregnancy, the outcome of pregnancy, and the type of study. And they were the sources of heterogeneity.Conclusion: Our results show that women who became pregnant after the treatment of breast cancer had a significantly better overall survival compared with those who did not become pregnant. Pregnancy subsequent to breast cancer does not adversely affect the disease prognosis. |
PDF Full Text Request