Pregnancy after breast cancer: Are young patients willing to participate in clinical studies?

Olivia Pagani; Monica Ruggeri; Silvia Manunta; Christobel Saunders; Fedro Peccatori; Fatima Cardoso; Bella Kaufman; Shani Paluch-Shimon; Hanan Gewefel; Elisa Gallerani; O Malkahi Abulkhair; Barbara Pistilli; Ellen Warner; Emmanouil Saloustros; Lucien Perey; Khalil Zaman; Manuela Rabaglio; Shari Gelber; Richard D Gelber; Aron Goldhirsch; Larissa Korde; Hatem A Azim Jr; Ann H Partridge

doi:10.1016/j.breast.2015.01.005

Pregnancy after breast cancer: Are young patients willing to participate in clinical studies?

Breast. 2015 Jun;24(3):201-7. doi: 10.1016/j.breast.2015.01.005. Epub 2015 Feb 4.

Authors

Olivia Pagani¹, Monica Ruggeri², Silvia Manunta³, Christobel Saunders⁴, Fedro Peccatori⁵, Fatima Cardoso⁶, Bella Kaufman⁷, Shani Paluch-Shimon⁷, Hanan Gewefel⁸, Elisa Gallerani⁹, O Malkahi Abulkhair¹⁰, Barbara Pistilli¹¹, Ellen Warner¹², Emmanouil Saloustros¹³, Lucien Perey¹⁴, Khalil Zaman¹⁵, Manuela Rabaglio¹⁶, Shari Gelber¹⁷, Richard D Gelber¹⁷, Aron Goldhirsch¹⁸, Larissa Korde¹⁹, Hatem A Azim Jr²⁰, Ann H Partridge²¹

Affiliations

¹ Oncology Institute of Southern Switzerland (IOSI), 6500 Bellinzona, Switzerland; International Breast Cancer Study Group (IBCSG), Effingerstrasse 40, 3008 Bern, Switzerland. Electronic address: olivia.pagani@ibcsg.org.
² International Breast Cancer Study Group (IBCSG), Effingerstrasse 40, 3008 Bern, Switzerland.
³ Oncology Institute of Southern Switzerland (IOSI), 6500 Bellinzona, Switzerland.
⁴ School of Surgery, University of Western Australia, Perth, WA 6009, Australia.
⁵ Fertility & Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology (IEO), Via Ripamonti 435, 20141 Milan, Italy.
⁶ Breast Unit, Champalimaud Cancer Centre, Av. De Brasília, Doca de Pedrouços, 1400 - 038 Lisbon, Portugal.
⁷ Breast Cancer Service for Young Women, Oncology Institute, Sheba Medical Center, Tel Hashomer, 52621, Israel.
⁸ Woman and Fetal Imaging Clinic (WAFI), 2 Mohamed Farid Wagdy St., Suite41 Manial Al Roda Island, Cairo, Egypt.
⁹ Ospedale Multimedica, Viale Piemonte 70, Castellanza, VA, Italy.
¹⁰ Department of Oncology, King Abdul Aziz Medical City for National Guard, Riyadh, Saudi Arabia.
¹¹ Oncology Department Macerata Hospital, Via S. Lucia 1, 62100 Macerata, Italy.
¹² Sunnybrook Health Sciences Centre, Odette Cancer Centre, Medical Oncology, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
¹³ Hereditary Cancer Clinic, Dpt of Medical Oncology, University Hospital of Heraklion, Voutes, Box 1352, Heraklion 71110, Greece.
¹⁴ Greeceo Unité d'oncologie, Ensemble hospitalier de la Côte, Hôpital de Morges, Morges and Centre pluridisciplinaire d'oncologie (CePO), CHUV, Lausanne, Switzerland.
¹⁵ CHUV-Centre d'Oncologie, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
¹⁶ Universitätsklinik und Poliklinik für Medizinische Onkologie/Brust-und Tumor Zentrum der Frauenklinik, Inselspital, Freiburgstrasse, 3010 Bern, Switzerland.
¹⁷ IBCSG Statistical Center, Dana-Farber Cancer Institute, Frontier Science and Technology Research Foundation, Boston, MA, USA.
¹⁸ International Breast Cancer Study Group (IBCSG), Effingerstrasse 40, 3008 Bern, Switzerland; Program of Breast Health, European Institute of Oncology (IEO), Via Ripamonti, 435, 20141 Milano, Italy.
¹⁹ Division of Medical Oncology, University of Washington, Seattle, WA, USA.
²⁰ Department of Medicine, BrEAST Data Centre, Institut Jules Bordet, Université Libre de, Bruxelles, Brussels, Belgium.
²¹ Dana-Farber Cancer Institute, 450 Brookline Avenue, Yawkey 12, Boston, MA 02215, USA.

PMID: 25662412
DOI: 10.1016/j.breast.2015.01.005

Abstract

Young patients with breast cancer (BC) are often concerned about treatment-induced infertility and express maternity desire. Conception after BC does not seem to affect outcome, but information in estrogen-receptor positive (ER+) disease is not definitive. From September 2012-March 2013, 212 evaluable patients with ER+ early BC, <37 years at diagnosis, from 5 regions (Europe/US/Canada/Middle-East/Australia) answered a survey about fertility concerns, maternity desire and interest in a study of endocrine therapy (ET) interruption to allow pregnancy. Overall, 37% of respondents were interested in the study; younger patients (≤30 years) reported higher interest (57%). Motivation in younger patients treated >30 months was higher (83%) than in older women (14%), interest was independent of age in patients treated for ≤30 months. A prospective study in this patient population seems relevant and feasible. The International-Breast-Cancer-Study-Group (IBCSG), within the Breast-International-Group (BIG) - North-American-Breast-Cancer-Groups (NABCG) collaboration, is launching a study (POSITIVE) addressing ET interruption to allow pregnancy.

Keywords: Breast cancer; Endocrine treatment; Estrogen receptor; Pregnancy; Young patients.

MeSH terms

Adult
Age Factors
Breast Neoplasms / chemistry
Breast Neoplasms / drug therapy
Breast Neoplasms / pathology
Breast Neoplasms / psychology*
Clinical Trials as Topic / psychology
Feasibility Studies
Female
Fertility Preservation / methods
Fertility Preservation / psychology*
Humans
Patient Participation / psychology*
Pregnancy
Pregnancy Complications, Neoplastic / drug therapy
Pregnancy Complications, Neoplastic / pathology
Pregnancy Complications, Neoplastic / psychology*
Receptors, Estrogen
Surveys and Questionnaires
Withholding Treatment*

Substances

Receptors, Estrogen