Pregnancy after breast cancer treatment has become an important issue since many young breast cancer patients have not completed their family. Generally, these patients should not be discouraged to become pregnant when they want to, since published data suggest no adverse effect of pregnancy on survival. As fertility may be impaired by chemotherapy, different fertility preserving strategies have been developed. Births seem to sustain no adverse effects, while breastfeeding appears to be feasible and safe.
"Therefore, young women with a diagnosis of breast cancer face the uncertainty of whether they have the ability to become pregnant after cancer treatments. Current evidence supports that childbearing after breast cancer is not contra-indicated (Hickey et al., 2009; de Bree et al., 2010; Pagani et al., 2011). However, individualized counselling is warranted, regarding prognosis and risk of relapse based on age and cancer pathological features, before patients can make informed reproductive decisions (Banks and Reeves, 2007; Hickey et al., 2009). "
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND
Young breast cancer survivors often need to deal with adverse effects of treatments on fertility and complex reproductive decisions. In this systematic review, we highlight what is known about childbearing and parenthood attitudes and decisions of young breast cancer survivors from their own perspective.METHODS
We conducted manual and electronic searches on Pubmed, PsychInf and CINAHL databases for articles, published in English between 1 January 1990 and 31 October 2012, that assessed childbearing, pregnancy and parenthood attitudes/decisions of female breast cancer survivors (premenopausal and/or <50 years old). Eligible articles were classified into quantitative studies, qualitative studies and mixed methods studies. Data from each study were individually extracted by all the authors, and standardized tables were created and discussed to ensure congruence of the information extracted.RESULTSOf the 493 publications identified in PubMed (results are presented for PubMed searches as the other databases did not yield any new relevant papers), 8 met the inclusion criteria, in addition to 2 publications retrieved manually. A total of 10 studies provided information on pregnancy and parenthood attitudes and decisions, in addition to risks and benefits of childbearing after breast cancer. Survivors had mixed attitudes towards the issue. Fear associated with future pregnancy was reported, namely the risk of cancer recurrence. However, for many survivors, pregnancy and parenthood can represent normalcy, happiness and life fulfilment.CONCLUSIONS
Childbearing after breast cancer is an important issue for survivors. Future larger and prospective studies should be implemented to increase certainty of conclusions of current research. Clinicians may benefit from a deeper understanding of the importance of pregnancy and parenthood to survivors in order to provide the needed educational and psychosocial support services, overcome misinformation and better assist women with their fertility-related decisions.
Human Reproduction Update 09/2013; 20(2). DOI:10.1093/humupd/dmt039 · 10.17 Impact Factor
"Pregnancy complications and the subsequent risk to the fetus are another concern for cancer patients. A review of pregnancies in patients previously treated for breast cancer reported variable outcomes . This meta-analysis evaluated 6 studies reporting birth outcome data after breast cancer compared to women without breast cancer. "
[Show abstract][Hide abstract] ABSTRACT: Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options. This review will summarize the risk of infertility secondary to cancer treatment, available treatment options for fertility preservation, and techniques to reduce future risks for patients. Concerns that will be addressed include the risk of the medications and procedures, the potential delay in cancer treatment, likelihood of pregnancy complications, as well as the impact of future pregnancy on the recurrence risk of cancer. Recent advances in oocyte cryopreservation and ovarian stimulation protocols will be discussed. Healthcare providers need to be informed of available treatment options including the risks, advantages, and disadvantages of fertility preserving options to properly counsel patients.
Obstetrics and Gynecology International 03/2012; 2012(1):953937. DOI:10.1155/2012/953937
[Show abstract][Hide abstract] ABSTRACT: Pregnancy after a chemotherapy for breast cancer is no longer a rare event. The example of two women who started a spontaneous pregnancy after a chemotherapy proves it. Patient education, better knowledge of medicines and their side effects as well as the possibilities of assisted reproduction techniques now-a-days allow willing women to consider a pregnancy in secure conditions for mother and child.
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