Pregnancy after breast cancer: A need for global patient care, starting before adjuvant therapy

Surgical Oncology

Volumn 19, Issue 1, 2010, Pages

  Chabbert Buffet, Nathalie ^a,b   Uzan, Catherine ^a,c   Gligorov, Joseph ^a   Delaloge, Suzette ^a,c   Rouzier, Roman ^a,b   Uzan, Serge ^a,b  

^a HÔPITAL TENON   (France)

^b SORBONNE UNIVERSITÉ   (France)

^c INSTITUT GUSTAVE ROUSSY   (France)

Author keywords

Breast cancer; Fertility chemotherapy; Information; Pregnancy; Prognosis

Indexed keywords

CYCLOPHOSPHAMIDE; DOCETAXEL; DOXORUBICIN; EPIRUBICIN; FLUOROURACIL; GOSERELIN; LETROZOLE; METHOTREXATE; PACLITAXEL; RECOMBINANT FOLLITROPIN; TAMOXIFEN; TRASTUZUMAB; ANTINEOPLASTIC AGENT;

AMENORRHEA; BREAST CANCER; CANCER ADJUVANT THERAPY; CANCER COMBINATION CHEMOTHERAPY; CANCER PATIENT; CLINICAL TRIAL; CRYOPRESERVATION; FEMALE FERTILITY; FEMALE INFERTILITY; FERTILIZATION IN VITRO; HUMAN; OVARY FUNCTION; OVARY INSUFFICIENCY; PATIENT CARE; PREGNANCY; PRIORITY JOURNAL; REVIEW; ADJUVANT CHEMOTHERAPY; BREAST NEOPLASMS; CHEMICALLY INDUCED; DECISION MAKING; FEMALE; FERTILITY; OOCYTE RETRIEVAL; PREMATURE OVARIAN FAILURE; PRENATAL CARE; PROGNOSIS; TIME;

ANTINEOPLASTIC AGENTS; BREAST NEOPLASMS; CHEMOTHERAPY, ADJUVANT; DECISION MAKING; FEMALE; FERTILITY; HUMANS; INFERTILITY, FEMALE; OOCYTE RETRIEVAL; OVARIAN FAILURE, PREMATURE; PREGNANCY; PRENATAL CARE; PROGNOSIS; TIME FACTORS; PRIMARY OVARIAN INSUFFICIENCY;

EID: 76049122366     PISSN: 09607404     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.suronc.2009.03.009     Document Type: Review

References (97)

1. Bonadonna G., Brusamolino E., Valagussa P., Rossi A., Brugnatelli L., Brambilla C., et al. Combination chemotherapy as an adjuvant treatment in operable breast cancer. The New England Journal of Medicine 294 8 (1976) 405-410
2. Fisher B., Carbone P., Economou S.G., Frelick R., Glass A., Lerner H., et al. 1-Phenylalanine mustard (l-PAM) in the management of primary breast cancer. A report of early findings. The New England journal of medicine 292 3 (1975) 117-122
3. Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early breast cancer trialists' collaborative group. Lancet 339 8784 (1992) 1-15
4. Hortobagyi G.N. Trastuzumab in the treatment of breast cancer. The New England journal of medicine 353 16 (2005) 1734-1736
5. Goldhirsch A., Wood W.C., Gelber R.D., Coates A.S., Thurlimann B., and Senn H.J. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol 18 7 (2007) 1133-1144
6. National Cancer Comprehensive Network. Available from: .
7. Goldhirsch A., Glick J.H., Gelber R.D., Coates A.S., Thurlimann B., Senn H.J., et al. Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005. Annals of Oncology 16 10 (2005) 1569-1583
8. Adjuvant online. Available from: .
9. Nabholtz J.M., and Gligorov J. The role of taxanes in the treatment of breast cancer. Expert Opinion on Pharmacotherapy 6 7 (2005) 1073-1094
10. Jones S.E., Savin M.A., Holmes F.A., O'Shaughnessy J.A., Blum J.L., Vukelja S., et al. Phase III trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer. Journal of Clinical Oncology 24 34 (2006) 5381-5387
11. Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocrine Reviews 17 2 (1996) 121-155
12. Ruess M.L., Kline J., Santos R., Levin B., and Timor-Tritsch I. Age and the ovarian follicle pool assessed with transvaginal ultrasonography. American Journal of Obstetrics and Gynecology 174 2 (1996) 624-627
13. Chiarelli A.M., Marrett L.D., and Darlington G. Early menopause and infertility in females after treatment for childhood cancer diagnosed in 1964-1988 in Ontario, Canada. American Journal of Epidemiology 150 3 (1999) 245-254
14. Falcone T., and Bedaiwy M.A. Fertility preservation and pregnancy outcome after malignancy. Current Opinion in Obstetrics & Gynecology 17 1 (2005) 21-26
15. Kil W.J., Ahn S.D., Shin S.S., Lee S.W., Choi E.K., Kim J.H., et al. Treatment-induced menstrual changes in very young (<35 years old) breast cancer patients. Breast Cancer Research and Treatment 96 3 (2006) 245-250
16. Goodwin P.J., Ennis M., Pritchard K.I., Trudeau M., and Hood N. Risk of menopause during the first year after breast cancer diagnosis. Journal of Clinical Oncology 17 8 (1999) 2365-2370
17. Swain S., Land S., Ritter M., Costantino J., Cecchini R., Mamounas E., et al. Amenorrhea in premenopausal women on the doxorubicin-and-cyclophosphamide-followed-by-docetaxel arm of NSABP B-30 trial. Breast Cancer Research and Treatment 113 2 (2009) 315-320
18. Christodoulakos G., Lambrinoudaki I., Panoulis C., Sioulas V., Rizos D., Caramalis G., et al. Serum androgen levels and insulin resistance in postmenopausal women: association with hormone therapy, tibolone and raloxifene. Maturitas 50 4 (2005) 321-330
19. Harper-Wynne C.L., Sacks N.P., Shenton K., MacNeill F.A., Sauven P., Laidlaw I.J., et al. Comparison of the systemic and intratumoral effects of tamoxifen and the aromatase inhibitor vorozole in postmenopausal patients with primary breast cancer. Journal of Clinical Oncology 20 4 (2002) 1026-1035
20. Lasco A., Cannavo S., Gaudio A., Morabito N., Basile G., Nicita-Mauro V., et al. Effects of long-lasting raloxifene treatment on serum prolactin and gonadotropin levels in postmenopausal women. European journal of endocrinology/European Federation of Endocrine Societies 147 4 (2002) 461-465
21. Ellmen J., Hakulinen P., Partanen A., and Hayes D.F. Estrogenic effects of toremifene and tamoxifen in postmenopausal breast cancer patients. Breast Cancer Research and Treatment 82 2 (2003) 103-111
22. Whitehead E., Shalet S.M., Jones P.H., Beardwell C.G., and Deakin D.P. Gonadal function after combination chemotherapy for Hodgkin's disease in childhood. Archives of disease in childhood 57 4 (1982) 287-291
23. Whitehead E., Shalet S.M., Blackledge G., Todd I., Crowther D., and Beardwell C.G. The effect of combination chemotherapy on ovarian function in women treated for Hodgkin's disease. Cancer 52 6 (1983) 988-993
24. Wallace W.H., Shalet S.M., Crowne E.C., Morris-Jones P.H., Gattamaneni H.R., and Price D.A. Gonadal dysfunction due to cis-platinum. Medical and Pediatric Oncology 17 5 (1989) 409-413
25. Larsen E.C., Muller J., Rechnitzer C., Schmiegelow K., and Andersen A.N. Diminished ovarian reserve in female childhood cancer survivors with regular menstrual cycles and basal FSH <10 IU/l. Human Reproduction (Oxford, England) 18 2 (2003) 417-422
26. McCarthy N.J. Care of the breast cancer survivor: increased survival rates present a new set of challenges. Postgraduate medicine 116 4 (2004) 39-40 2, 5-6
27. Minton S.E., and Munster P.N. Chemotherapy-induced amenorrhea and fertility in women undergoing adjuvant treatment for breast cancer. Cancer Control 9 6 (2002) 466-472
28. Stearns V., Schneider B., Henry N.L., Hayes D.F., and Flockhart D.A. Breast cancer treatment and ovarian failure: risk factors and emerging genetic determinants. Nature Reviews 6 11 (2006) 886-893
29. Hortobagyi G.N., Buzdar A.U., Marcus C.E., and Smith T.L. Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute. NCI Monographs 1 (1986) 105-109
30. Roche H., Fumoleau P., Spielmann M., Canon J.L., Delozier T., Serin D., et al. Sequential adjuvant epirubicin-based and docetaxel chemotherapy for node-positive breast cancer patients: the FNCLCC PACS 01 trial. Journal of Clinical Oncology 24 36 (2006) 5664-5671
31. Fornier M.N., Modi S., Panageas K.S., Norton L., and Hudis C. Incidence of chemotherapy-induced, long-term amenorrhea in patients with breast carcinoma age 40 years and younger after adjuvant anthracycline and taxane. Cancer 104 8 (2005) 1575-1579
32. Tham Y.L., Sexton K., Weiss H., Elledge R., Friedman L.C., and Kramer R. The rates of chemotherapy-induced amenorrhea in patients treated with adjuvant doxorubicin and cyclophosphamide followed by a taxane. American Journal of Clinical Oncology 30 2 (2007) 126-132
33. Anderson R.A., Themmen A.P., Al-Qahtani A., Groome N.P., and Cameron D.A. The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer. Human Reproduction (Oxford, England) 21 10 (2006) 2583-2592
34. Lutchman Singh K., Davies M., and Chatterjee R. Fertility in female cancer survivors: pathophysiology, preservation and the role of ovarian reserve testing. Human Reproduction Update 11 1 (2005) 69-89
35. Giuseppe L., Attilio G., Edoardo D.N., Loredana G., Cristina L., and Vincenzo L. Ovarian function after cancer treatment in young women affected by Hodgkin disease (HD). Hematology 12 2 (2007) 141-147
36. Fanchin R., Schonauer L.M., Righini C., Guibourdenche J., Frydman R., and Taieb J. Serum anti-Mullerian hormone is more strongly related to ovarian follicular status than serum inhibin B, estradiol, FSH and LH on day 3. Human Reproduction (Oxford, England) 18 2 (2003) 323-327
37. van Rooij I.A., Broekmans F.J., te Velde E.R., Fauser B.C., Bancsi L.F., de Jong F.H., et al. Serum anti-Mullerian hormone levels: a novel measure of ovarian reserve. Human Reproduction (Oxford, England) 17 12 (2002) 3065-3071
38. van Rooij I.A., Broekmans F.J., Scheffer G.J., Looman C.W., Habbema J.D., de Jong F.H., et al. Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: a longitudinal study. Fertility and Sterility 83 4 (2005) 979-987
39. Mohamed K.A., Davies W.A., and Lashen H. Antimullerian hormone and pituitary gland activity after prolonged down-regulation with goserelin acetate. Fertility and Sterility 86 5 (2006) 1515-1517
40. Anders C., Marcom P.K., Peterson B., Gu L., Unruhe S., Welch R., et al. A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer. Cancer Investigation 26 3 (2008) 286-295
41. de Bruin J.P., Bovenhuis H., van Noord P.A., Pearson P.L., van Arendonk J.A., te Velde E.R., et al. The role of genetic factors in age at natural menopause. Human Reproduction (Oxford, England) 16 9 (2001) 2014-2018
42. Nippita T.A., and Baber R.J. Premature ovarian failure: a review. Climacteric 10 1 (2007) 11-22
43. Mackie E.J., Radford M., and Shalet S.M. Gonadal function following chemotherapy for childhood Hodgkin's disease. Medical and Pediatric Oncology 27 2 (1996) 74-78
44. Schilsky R.L., Sherins R.J., Hubbard S.M., Wesley M.N., Young R.C., and DeVita V.T. Long-term follow up of ovarian function in women treated with MOPP chemotherapy for Hodgkin's disease. American Journal of Medicine 71 4 (1981) 552-556
45. Magelssen H., Melve K.K., Skjaerven R., and Fossa S.D. Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood. Human Reproduction (Oxford, England) 23 1 (2008) 178-186
46. Gerber B., Dieterich M., Muller H., and Reimer T. Controversies in preservation of ovary function and fertility in patients with breast cancer. Breast Cancer Research and Treatment (2007)
47. Pritchard K.I. Adjuvant therapy for premenopausal women with breast cancer: is it time for another paradigm shift?. Journal of Clinical Oncology 20 24 (2002) 4611-4614
48. Swain SM, Jeong J-H, Geyer CE, Costantino JP, Pajon ER, Fehrenbacher L, et al. NSABP B-30: definitive analysis of patient outcome from a randomized trial evaluating different schedules and combinations of adjuvant therapy containing doxorubicin, docetaxel and cyclophosphamide in women with operable, node-positive breast cancer. San Antonio Breast Cancer Symposium 2008 Abstract #75.
49. Early Breast Cancer Trialists' Collabortaive Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. The Lancet 2005; 365 (9472): 1687-717.
50. Colleoni M., Gelber S., Goldhirsch A., Aebi S., Castiglione-Gertsch M., Price K.N., et al. Tamoxifen after adjuvant chemotherapy for premenopausal women with lymph node-positive breast cancer: international breast cancer study group trial 13-93. Journal of Clinical Oncology 24 9 (2006) 1332-1341
51. Walshe J.M., Denduluri N., and Swain S.M. Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. Journal of Clinical Oncology 24 36 (2006) 5769-5779
52. Vanhuyse M., Fournier C., and Bonneterre J. Chemotherapy-induced amenorrhea: influence on disease-free survival and overall survival in receptor-positive premenopausal early breast cancer patients. Annals of Oncology 16 8 (2005) 1283-1288
53. Rocca W.A., Grossardt B.R., de Andrade M., Malkasian G.D., and Melton III L.J. Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncology 7 10 (2006) 821-828
54. Parton M., and Smith I.E. Controversies in the management of patients with breast cancer: adjuvant endocrine therapy in premenopausal women. Journal of Clinical Oncology 26 5 (2008) 745-752
55. Rabaglio M., Aebi S., and Castiglione-Gertsch M. Controversies of adjuvant endocrine treatment for breast cancer and recommendations of the 2007 St Gallen conference. Lancet Oncology 8 10 (2007) 940-949
56. Ataya K., Rao L.V., Lawrence E., and Kimmel R. Luteinizing hormone-releasing hormone agonist inhibits cyclophosphamide- induced ovarian follicular depletion in rhesus monkeys. Biology of Reproduction 52 2 (1995) 365-372
57. McGee E.A., and Hsueh A.J. Initial and cyclic recruitment of ovarian follicles. Endocrine Reviews 21 2 (2000) 200-214
58. Pru J.K., and Tilly J.L. Programmed cell death in the ovary: insights and future prospects using genetic technologies. Molecular Endocrinology 15 6 (2001) 845-853
59. Brougham M.F., and Wallace W.H. Subfertility in children and young people treated for solid and haematological malignancies. British Journal of Haematology 131 2 (2005) 143-155
60. Recchia F., Saggio G., Amiconi G., Blasio A.D., Cesta A., Candeloro G., et al. Gonadotropin-releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma. Cancer 106 3 (2006) 514-523
61. Blumenfeld Z. Preservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and -B as markers. Molecular and Cellular Endocrinology 187 1-2 (2002) 93-105
62. Franke H.R., Smit W.M., and Vermes I. Gonadal protection by a gonadotropin-releasing hormone agonist depot in young women with Hodgkin's disease undergoing chemotherapy. Gynaecological Endocrinology 20 5 (2005) 274-278
63. Pereyra Pacheco B., Mendez Ribas J.M., Milone G., Fernandez I., Kvicala R., Mila T., et al. Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecologic Oncology 81 3 (2001) 391-397
64. Recchia F., Saggio G., Amiconi G., Di Blasio A., Cesta A., Candeloro G., et al. Gonadotropin-releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma. Cancer 106 3 (2006) 514-523
65. Poirot C., Vacher-Lavenu M.C., Helardot P., Guibert J., Brugieres L., and Jouannet P. Human ovarian tissue cryopreservation: indications and feasibility. Human Reproduction (Oxford, England) 17 6 (2002) 1447-1452
66. von Wolff M, Donnez J, Hovatta O, Keros V, Maltaris T, Montag M, Salle B, Sonmezer M, Andersen CY. Cryopreservation and autotransplantation of human ovarian tissue prior to cytotoxic therapy - a technique in its infancy but already successful in fertility preservation. European Journal of Cancer, 2009 March [Epub ahead of print]
67. Oktay K., Buyuk E., Davis O., Yermakova I., Veeck L., and Rosenwaks Z. Fertility preservation in breast cancer patients: IVF and embryo cryopreservation after ovarian stimulation with tamoxifen. Human Reproduction (Oxford, England) 18 1 (2003) 90-95
68. Oktay K., Hourvitz A., Sahin G., Oktem O., Safro B., Cil A., et al. Letrozole reduces estrogen and gonadotropin exposure in women with breast cancer undergoing ovarian stimulation before chemotherapy. Journal of Clinical Endocrinology & Metabolism 91 10 (2006) 3885-3890
69. Oktay K., Buyuk E., Libertella N., Akar M., and Rosenwaks Z. Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. J Clin Oncol 23 19 (2005) 4347-4353
70. Requena A., Herrero J., Landeras J., Navarro E., Neyro J.L., Salvador C., et al. Use of letrozole in assisted reproduction: a systematic review and meta-analysis. Human Reproduction Update 14 6 (2008) 571-582
71. Gook D.A., and Edgar D.H. Human oocyte cryopreservation. Human Reproduction Update 13 6 (2007) 591-605
72. Chian R.-C., Huang J.Y.J., Tan S.L., Lucena E., Saa A., Rojas A., et al. Obstetric and perinatal outcome in 200 infants conceived from vitrified oocytes. Reproductive BioMedicine Online 16 (2008) 608-610
73. Cooper D.R., and Butterfield J. Pregnancy subsequent to mastectomy for cancer of the breast. Annals of Surgery 171 3 (1970) 429-433
74. Ariel I.M., and Kempner R. The prognosis of patients who become pregnant after mastectomy for breast cancer. International Surgery 74 3 (1989) 185-187
75. Gelber S., Coates A.S., Goldhirsch A., Castiglione-Gertsch M., Marini G., Lindtner J., et al. Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer. J Clin Oncol 19 6 (2001) 1671-1675
76. Kroman N., Jensen M.B., Melbye M., Wohlfahrt J., and Mouridsen H.T. Should women be advised against pregnancy after breast-cancer treatment?. Lancet 350 9074 (1997) 319-322
77. Sankila R., Heinavaara S., and Hakulinen T. Survival of breast cancer patients after subsequent term pregnancy: "healthy mother effect". American Journal of Obstetrics and Gynecology 170 3 (1994) 818-823
78. von Schoultz E., Johansson H., Wilking N., and Rutqvist L.E. Influence of prior and subsequent pregnancy on breast cancer prognosis. Journal of Clinical Oncology 13 2 (1995) 430-434
79. Ives A., Saunders C., Bulsara M., and Semmens J. Pregnancy after breast cancer: population based study. BMJ (Clinical Research Ed) 334 7586 (2007) 194
80. Blakely L.J., Buzdar A.U., Lozada J.A., Shullaih S.A., Hoy E., Smith T.L., et al. Effects of pregnancy after treatment for breast carcinoma on survival and risk of recurrence. Cancer 100 3 (2004) 465-469
81. Averette H.E., Mirhashemi R., and Moffat F.L. Pregnancy after breast carcinoma: the ultimate medical challenge. Cancer 85 11 (1999) 2301-2304
82. Ravdin P.M., Siminoff L.A., Davis G.J., Mercer M.B., Hewlett J., Gerson N., et al. Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. Journal of Clinical Oncology 19 4 (2001) 980-991
83. Rastogi P., Anderson S.J., Bear H.D., Geyer C.E., Kahlenberg M.S., Robidoux A., et al. Preoperative chemotherapy: updates of national surgical adjuvant breast and bowel project protocols B-18 and B-27. Journal of Clinical Oncology 26 5 (2008) 778-785
84. Andrieu N., Easton D.F., Chang-Claude J., Rookus M.A., Brohet R., Cardis E., et al. Effect of chest X-rays on the risk of breast cancer among BRCA1/2 mutation carriers in the international BRCA1/2 carrier cohort study: a report from the EMBRACE, GENEPSO, GEO-HEBON, and IBCCS collaborators' group. Journal of Clinical Oncology 24 21 (2006) 3361-3366
85. Cullinane C.A., Lubinski J., Neuhausen S.L., Ghadirian P., Lynch H.T., Isaacs C., et al. Effect of pregnancy as a risk factor for breast cancer in BRCA1/BRCA2 mutation carriers. International Journal of Cancer 117 6 (2005) 988-991
86. Venn A., Watson L., Bruinsma F., Giles G., and Healy D. Risk of cancer after use of fertility drugs with in-vitro fertilisation. Lancet 354 9190 (1999) 1586-1590
87. Kotsopoulos J., Librach C.L., Lubinski J., Gronwald J., Kim-Sing C., Ghadirian P., et al. Infertility, treatment of infertility, and the risk of breast cancer among women with BRCA1 and BRCA2 mutations: a case-control study. Cancer Causes & Control 19 10 (2008) 1111-1119
88. Azim A.A., Costantini-Ferrando M., and Oktay K. Safety of fertility preservation by ovarian stimulation with letrozole and gonadotropins in patients with breast cancer: a prospective controlled study. Journal of Clinical Oncology 26 16 (2008) 2630-2635
89. Barry E., Alvarez J.A., Scully R.E., Miller T.L., and Lipshultz S.E. Anthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management. Expert Opinion on Pharmacotherapy 8 8 (2007) 1039-1058
90. Elliott P. Pathogenesis of cardiotoxicity induced by anthracyclines. Seminars in Oncology 33 Suppl. 8 (2006) 2-7
91. Jensen B.V. Cardiotoxic consequences of anthracycline-containing therapy in patients with breast cancer. Seminars in Oncology 33 Suppl. 8 (2006) 15-21
92. van Dalen E.C., van der Pal H.J.H., van den Bos C., Kok W.E.M., Caron H.N., and Kremer L.C.M. Clinical heart failure during pregnancy and delivery in a cohort of female childhood cancer survivors treated with anthracyclines. European Journal of Cancer 42 15 (2006) 2549-2553
93. Goethals I., De Winter O., De Bondt P., De Sutter J., Dierckx R., and Van De Wiele C. The clinical value of nuclear medicine in the assessment of irradiation-induced and anthracycline-associated cardiac damage. Annals of Oncology 13 9 (2002) 1331-1339
94. Tralins A.H. Lactation after conservative breast surgery combined with radiation therapy. American Journal of Clinical Oncology 18 1 (1995) 40-43
95. Langagergaard V., Gislum M., Skriver M.V., Norgard B., Lash T.L., Rothman K.J., et al. Birth outcome in women with breast cancer. British Journal of Cancer 94 1 (2006) 142-146
96. Dalberg K., Eriksson J., and Holmberg L. Birth outcome in women with previously treated breast cancer - a population-based cohort study from Sweden. PLoS Medicine 3 9 (2006) e336
97. Rouzier R., Uzan C., Lesieur B., Vercambre M., and Chabbert-Buffet N. Are pregnancy and ART reasonable after breast cancer? MT Medecine de la Reproduction. Gynécologie Endocrinologie 10 4 (2008) 238-242