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Racial Differences in Live-Birth Outcomes After a Breast Cancer Diagnosis.

Mary Kathryn Abel1, Alexa Kanbergs1, Chi-Fang Wu1

  • 1Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; the Department of Gynecologic Oncology and Reproductive Medicine and the Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas; and Unidad Ginecología Oncológica, Grupo de Investigación GIGA, Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), and Clínica Universitaria Colombia, Bogotá, Colombia.

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Summary

Breast cancer significantly reduces live-birth rates for young women. Fertility impacts vary by race and ethnicity, with non-Hispanic Asian women showing increased fertility post-diagnosis.

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Area of Science:

  • Oncology
  • Reproductive Health
  • Health Disparities

Background:

  • Breast cancer is the most common cancer in young women.
  • Cancer treatments can negatively impact fertility.
  • Racial and ethnic disparities in cancer outcomes are known, but their effect on fertility is less understood.

Purpose of the Study:

  • To evaluate racial and ethnic differences in live-birth rates among young women diagnosed with breast cancer.
  • To compare post-cancer fertility rates with the general population.

Main Methods:

  • Utilized linked data from California and National Center for Health Statistics bridged-race population estimates.
  • Analyzed data for 25,448 women aged 20-49 diagnosed with stage I-III breast cancer (2000-2012).
  • Compared live-birth rates between breast cancer survivors and women without cancer, stratified by race and ethnicity.

Main Results:

  • Breast cancer was associated with a 58% reduction in live-birth rate compared to women without cancer (birth-rate ratio 0.42).
  • Fertility reductions varied by race: 61% for non-Hispanic White, 50% for non-Hispanic Black, and 32% for Hispanic women.
  • Non-Hispanic Asian women experienced increased fertility (birth-rate ratio 2.21).

Conclusions:

  • Significant racial and ethnic differences exist in reproductive outcomes after breast cancer diagnosis.
  • These findings underscore the need for further research into factors influencing these disparities.
  • Tailored fertility preservation strategies may be necessary for diverse patient populations.