Time to Pregnancy, Obstetrical and Neonatal Outcomes after Breast Cancer: A Study from the Maternity Network for Young Breast Cancer Patients

SIMPLE SUMMARY: Little is known on the time necessary to obtain a pregnancy after breast cancer and on the subsequent obstetrical and neonatal outcomes. We analyzed a cohort of breast cancer survivors aged 18–43 years old at diagnosis and having at least one pregnancy after cancer. While 71% of patients attempted to be pregnant, 18% of pregnancies were unplanned. Most pregnancies (86%) were obtained spontaneously and a minority occurred after assisted reproductive technologies (11%). We showed that median time to evolutive pregnancy was 5.6 months, and only menstrual cycles before pregnancy was significantly associated with time to pregnancy after multivariate analysis. Neonatal outcomes were similar to general population, and none of the prior BC treatments affected parameters of newborns. Our findings provide reassuring data for pregnancy counseling both in terms of delay and outcome. Our results also highlight the importance of appropriate contraceptive counseling after breast cancer to avoid unplanned pregnancies. ABSTRACT: Although an increasing number of young breast cancer (BC) patients have a pregnancy desire after BC, the time necessary to obtain a pregnancy after treatment and subsequent outcomes remain unknown. We aimed to determine the time to evolutive pregnancy in a cohort of BC survivors and subsequent obstetrical and neonatal outcomes. We analyzed BC patients treated at Institut Curie from 2005–2017, aged 18–43 years old (y.o.) at diagnosis having at least one subsequent pregnancy. 133 patients were included, representing 197 pregnancies. Mean age at BC diagnosis was 32.8 y.o. and at pregnancy beginning was 36.8 y.o. 71% pregnancies were planned, 18% unplanned and 86% spontaneous. 64% pregnancies resulted in live birth (n = 131). Median time from BC diagnosis to pregnancy beginning was 48 months and was significantly associated with endocrine therapy (p < 0.001). Median time to pregnancy was 4.3 months. Median time to evolutive pregnancy 5.6 months. In multivariate analysis, menstrual cycles before pregnancy remained significantly associated with time to pregnancy and endocrine therapy with time evolutive to pregnancy. None of the BC treatments (chemotherapy/endocrine therapy/trastuzumab) was significantly associated with obstetrical nor neonatal outcomes, that seemed comparable to global population. Our findings provide reassuring data for pregnancy counseling both in terms of delay and outcome.