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Review
. 2025 Jun 18:17:17588359251346648.
doi: 10.1177/17588359251346648. eCollection 2025.

Pregnancy after breast cancer: latest evidence and practical considerations

Nadia Mordenfeld Kozlovsky  1 , Ann H Partridge  2   3 , Tal Sella  1
Affiliations
Review

Pregnancy after breast cancer: latest evidence and practical considerations

Nadia Mordenfeld Kozlovsky et al. Ther Adv Med Oncol. .

Abstract

Advancements in breast cancer care have significantly improved survival rates in women of all ages; however, young survivors face unique challenges related to fertility, pregnancy, and maternal-fetal health which may impact on their medical and psychosocial outcomes. Increasingly, young women are diagnosed with breast cancer before completing their reproductive plans and goals and may undergo gonadotoxic therapies and prolonged endocrine therapy with age-related fertility decline. Pretreatment counseling is critical to manage expectations, align reproductive and treatment goals, plan future childbearing opportunities, and refer for fertility preservation interventions when needed. Evidence supports the safety of pregnancy and breastfeeding in posttreatment scenarios, with individual risks and treatment histories carefully evaluated. The growing use of novel agents like CDK4/6 inhibitors, poly-ADP-ribose polymerase inhibitors, and immune checkpoint inhibitors for which there are little to no data regarding impact on fertility highlights the urgent need for further research in this area. Patient-centered, multidisciplinary approaches applied throughout the disease trajectory remain essential to support the reproductive health and overall quality of life of young breast cancer survivors navigating the reproductive complexities of modern breast cancer treatment.

Keywords: breast cancer; fertility; gonadotoxicity; pregnancy; young women.

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Conflict of interest statement

T.S. reports honorarium from Roche, Eli Lilly, Novartis, MSD, Gilead, Astrazeneca and Stemline, advisory from Novartis, Roche and travel support for Roche, Gilead, Oncotest, Pfizer, Stemline, and Astra-Zeneca. A.H.P. reports research support from Patient-Centered Outcomes Research Institute (AFT-25 COMET), Susan G. Komen, the Breast Cancer Research Foundation (BCRF) and the American Cancer Society (ACS); and royalties from Wolters Kluwer. NMK reports no relevant COI.

Figures

Figure 1.
Figure 1.
Pregnancy-related considerations before and after breast cancer treatment.
See this image and copyright information in PMC

References

    1. Ruddy KJ, Gelber SI, Tamimi RM, et al. Prospective study of fertility concerns and preservation strategies in young women with breast cancer. J Clin Oncol 2014; 32(11): 1151–1156. - PMC - PubMed
    1. Lambertini M, Fontana V, Massarotti C, et al. Prospective study to optimize care and improve knowledge on ovarian function and/or fertility preservation in young breast cancer patients: results of the pilot phase of the PREgnancy and FERtility (PREFER) study. Breast 2018; 41: 51–56. - PubMed
    1. Ruggeri M, Pagan E, Bagnardi V, et al. Fertility concerns, preservation strategies and quality of life in young women with breast cancer: baseline results from an ongoing prospective cohort study in selected European Centers. Breast 2019; 47: 85–92. - PubMed
    1. Lambertini M, Goldrat O, Clatot F, et al. Controversies about fertility and pregnancy issues in young breast cancer patients: current state of the art. Curr Opin Oncol 2017; 29(4): 243–252. - PubMed
    1. Poorvu PD, Frazier AL, Feraco AM, et al. Cancer treatment-related infertility: a critical review of the evidence. JNCI Cancer Spectr 2019; 3(1): pkz008. - PMC - PubMed

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