Breast cancer treatment--later pregnancy and survival

Although breast cancer (BC) affects patients at older age, it occurs more frequently in premenopausal women due to better diagnostic methods and an increasing trend towards delay in childbearing. The increasing population of women with BC delaying childbearing may be of concern regarding the effect of treatment on later pregnancy, as well as the influence of pregnancy on the prognosis of disease and survival. Radiotherapy has shown no adverse effects on the clinical outcome in the offspring except diminished lactation. The offspring of patients who became pregnant after chemotherapy have shown no congenital anomalies, although sometimes a high abortion rate (10-29%) has been demonstrated. Currently, several fertility-sparing options, including the use of endocrine therapy and assisted reproductive technologies, cryopreservation and ovarian tissue transplantation, are very promising. The survival of BC patients is not decreased by a subsequent pregnancy; compared with the non-pregnant group their survival rates are often the same or better, with favourable relative risks and lower recurrence of metastases.