Breastfeeding After Hormone Receptor–Positive Breast Cancer: Results From the POSITIVE Trial
Abstract
PURPOSE We investigated breastfeeding patterns, behaviors, and association with breast cancer (BC) outcomes in women with early hormone receptor–positive (HR+) BC who had a live birth in the POSITIVE trial. PATIENTS AND METHODS POSITIVE is a prospective trial that demonstrated no increased short-term risk of BC events in women with early HR+ BC who interrupted endocrine therapy (ET) to attempt pregnancy. We describe the frequency, duration, and laterality of breastfeeding and estimate the cumulative incidence of BC events by breastfeeding status. RESULTS At a median follow-up of 41 months, 317 patients had at least one live birth and 313 were eligible for this analysis. A total of 196 of 313 (62.6%) patients breastfed. A total of 130 of the 167 women (77.8%) who had breast-conserving surgery breastfed, and 90 of 130 (69.2%) breastfed from the unaffected breast only. Sixty-six of the 146 women (45.2%) who underwent unilateral mastectomy breastfed. The frequency of breastfeeding was higher in women older than 35 years (67.6% v 55.7%) and in those without previous children (66.4% v 48.5%). Over half (103 of 196, 52.6%) of women breastfed their first live birth for >4 months (median 4.4 months; 95% CI, 4.0 to 5.3). The cumulative incidence of a BC event at 24 months from first on-study live birth was 3.6% and 3.1% in the breastfeeding and nonbreastfeeding groups, respectively (0.5% difference; 95% CI, –4.3% to 5.2%). CONCLUSION In POSITIVE, two thirds of women who gave birth after BC diagnosis breastfed, mostly for 4 months or more. In early follow-up, we did not observe differences in BC-related events in women who breastfed compared with those who did not. These results are key for women who wish to pursue pregnancy and breastfeeding after BC.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (35)
Fedro A. Peccatori
Fertility and Procreation Unit, Gynecologic Oncology Program, European Institute of Oncology IRCCS, Milan, Italy
Samuel M. Niman
Dana-Farber Cancer Institute, Boston, MA
Ann H. Partridge
Dana–Farber Cancer Institute, Harvard Medical School, Boston
Monica Ruggeri
Program for Young Patients, International Breast Cancer Study Group, A Division of ETOP IBCSG Partners Foundation, Bern, Switzerland
Marco Colleoni
Cristina Saura
Vall d’Hebron University Hospital, Barcelona
Chikako Shimizu
Risako Komata, MD; Kenju Ando, MD, PhD; Akihiko Shimomura, MD, PhD; and Chikako Shimizu, MD, PhD, Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan
Anna B. Satersdal
Breast Cancer Unit, Division of Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, Norway
Judith R. Kroep
Leiden University Medical Center, Leiden, Netherlands
Karen Gelmon
BC Cancer Vancouver Centre, University of British Columbia, Vancouver, BC, Canada
Frédéric Amant
Audrey Mailliez
Department of Medical Oncology, Breast Cancer Unit, Centre Oscar Lambret, Lille, France
Halle C.F. Moore
Breast Oncology Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
Manuel Ruiz-Borrego
Department of Medical Oncology, Hospital Virgen del Rocío, Seville, Spain
Janice M. Walshe
Cancer Trials Ireland, Dublin, Ireland
Virginia F. Borges
University of Colorado Anschutz Medical Center, Aurora, CO
Andrea Gombos
Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium
Akemi Kataoka
Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
Christine Rousset-Jablonski
Department of Surgery, Leon Berard Cancer Centre, Centre Léon Bérard, Lyon, France
Simona Borstnar
Institute of Oncology, Ljubljana, Slovenia
Junko Takei
Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
Jeong E. Lee
Breast Division, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Christobel Saunders
Vesna Bjelic-Radisic
Department of Senology, Breast Center, Helios University Clinic Wuppertal, Wuppertal, Germany
Snezana Susnjar
Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
Fatima Cardoso
Natalie J. Klar
New York University Langone's Perlmutter Cancer Center, Breast Cancer Center, New York, NY
Teresa Ferreiro
Soul Reconnect, Barcelona, Spain
Sarra El-Abed
Breast International Group, Brussels, Belgium
Martine Piccart
Larissa A. Korde
Breast and Melanoma Therapeutics, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD
Aron Goldhirsch
International Breast Cancer Study Group, Division of ETOP IBCSG Partners Foundation, Bern, Switzerland
Richard D. Gelber
International Breast Cancer Study Group Statistical Center, Boston, MA
Olivia Pagani
Geneva University Hospitals, Geneva, Switzerland
Hatem A. Azim
Cairo Cure Oncology Center, Cairo, Egypt