Pregnancy is safe for women with estrogen receptor positive breast cancer

He concluded: “This is the first study to investigate the safety of pregnancy in breast cancer patients with ER+ disease, and which also adjusted for the ‘healthy mother effect’. It shows convincingly that pregnancy any time following breast cancer diagnosis is safe, irrespective of ER status. This study provides strong evidence to help proper counselling of women seeking to become pregnant following completion of breast cancer therapy. However, this study does not address the optimal duration of adjuvant hormonal therapy in these women.”

Score Predicts Late Recurrence in ER-Positive Breast Cancer
– A new gene-based biomarker assay may help to estimate prognosis and make decisions about extended endocrine therapy in women with estrogen receptor–positive early breast cancer, new data suggest.

Researchers tested the biomarker, the Breast Cancer Index (BCI), among 249 women with estrogen receptor–positive early breast cancer from the MA.17 trial, in which women received 5 years of adjuvant tamoxifen therapy and, if still disease free, were then randomized to an additional 5 years of either letrozole (Femara) or placebo.

Study results, reported at a breast cancer symposium sponsored by the American Society of Clinical Oncology, showed that with each 5-unit increase in the 10-unit BCI score, women’s odds of late recurrence nearly tripled.

The index as a whole was not helpful in predicting the benefit of added letrozole therapy in reducing recurrence risk. But one of its components, called H/I, was helpful: Women having a high H/I were about half as likely to have a recurrence if they received letrozole instead of placebo.

The study included any woman diagnosed with breast cancer before 2007 who matched the criteria for inclusion in the study. The patients had an average age of 34, ranging between 21-48 years old, with an equal proportion of patients receiving post-operative chemotherapy and hormonal therapy in both groups. Patients who did not become pregnant had to be free of cancer for an interval that was as long as the time that elapsed between a breast cancer diagnosis and the date of conception in the women who did become pregnant. The pregnant women were all in remission before conceiving.

Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and chair of EBCC-8 said: “This is an important study, as it can give women much more confidence that a wanted pregnancy after treatment for breast cancer does not necessarily mean a poorer chance of being able to live to bring up children. However, it is important to acknowledge that there are limitations in this kind of case control study, and so whilst an important piece of research, it cannot yet be taken as definitive proof that there is no adverse effect of a subsequent pregnancy. What it does suggest is that at worst any negative impact is small, and that it is likely that there is no detrimental effect of a subsequent pregnancy.”

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Abstract no: 21, Wednesday 15.45 hrs, “Why does age matter?” session, Hall F2.

[1] The institutions and organisations that contributed patients to the study were: Danish Breast Cancer Cooperative Group (Denmark), European Institute of Oncology (Milan, Italy), Jules Bordet Institute (Brussels, Belgium), Vall D’Hebron University Hospital (Barcelona, Spain), University of La Paz (Madrid, Spain), Macerata Hospital (Macerata, Italy), and the International Breast Cancer Study Group.
[2] The figures in this release are different to those in the abstract as they have been updated since the abstract was submitted.
[3] The study was funded by grants from the European School of Oncology and Les Amis de l’Institut Bordet.

 

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