[Nine Cases of Pregnancy and Delivery after Breast Cancer]

The present study reviewed 9 cases of pregnancy and delivery after breast cancer in our clinic, between 2007 and 2019, to evaluate treatment options for their safe and successful management. The mean age at primary surgery was 31.7 years(27- 37); the study included 1, 5, 2, and 1 cases of pTNM Stage 0, Ⅰ, ⅡA, and ⅡB, respectively. The pregnancies were allowed after at least 1 year since completion of treatment to wash out chemotherapy or endocrine therapy agents. There were a total of 17 natural pregnancies, including 15 natural deliveries and 2 spontaneous abortions. Four patients achieved 1 birth, 4 achieved 2 births, and 1 achieved 3 births. The mean age at the first delivery after surgery was 36 years(30-40), and the highest age at the last delivery was 45 years. The molecular subtypes of breast cancer involved included 5 Luminal types, 1 Luminal-HER2 type, 1 HER2-enrich type, and 2 triple-negative types. The mean interval between the primary surgery and the first delivery was 4.3 years(3-6). Six patients were disease-free, and 3 patients experienced recurrences. Among the 3 patients with recurrence, 1 patient suffered from a local recurrence 43 months after the surgery; it was successfully resected, and she delivered 2 children after the second surgery and is now disease-free. One patient delivered 2 children after surgery; 12 years after surgery, she suffered from bone metastasis, but fortunately, endocrine therapy plus zoledronic acid treatment induced complete remission. One patient achieved pregnancy 4 years after the surgery and routine examination demonstrated the liver and bone metastases. The patient safely delivered at 9th-month pregnancy; the metastases and recurrences were treated chemo-endocrine therapy, and the patient is currently doing well. In conclusion, although the present study includes only 9 patients with 15 births, it suggests that a safe and successful pregnancy and delivery can be achieved through a variety of patient-orientated post-surgical treatment options that consider fertility preservation.