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Childbirth in young Korean women with previously treated breast cancer: The SMARTSHIP study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Alongside the modern trend of delaying childbirth, the high incidence of breast cancer among young women is causing significant pregnancy-related problems in Korea. We estimated the incidence of childbirth for young Korean breast cancer survivors compared with women who did not have breast cancer using a nationally representative dataset.

Methods

Using a database from the National Health Insurance Service in South Korea, we analyzed 109,680 women who were between 20 and 40 years old between 2007 and 2013. They were prospectively followed, and childbirth events were recorded until December 31, 2015. We compared childbirth rates and characteristics between the breast cancer survivors and the noncancer controls.

Results

Compared to 10,164 childbirths among 91,400 women without breast cancer (incidence rate: 22.3/1000), 855 childbirths occurred among 18,280 breast cancer survivors (incidence rate: 9.4/1000); the adjusted hazard ratio (HR) for childbirth was 0.41 (95% CI 0.38–0.44). Chemotherapy, endocrine therapy, and target therapy were associated with the decreasing childbirths among survivors, with corresponding adjusted HRs of 0.61 (0.53–0.70), 0.44 (0.38–0.51), and 0.62 (0.45–0.86), respectively. Breast cancer survivors had a lower probability of full-term delivery and a higher frequency of preterm labor than controls, with corresponding adjusted ORs of 0.78 (0.68–0.90) and 1.33 (1.06–1.65), respectively.

Conclusions

We showed that a history of breast cancer has a negative effect on childbirth among young premenopausal women in Korea. Breast cancer survivors should be aware that they have a higher risk for preterm labor and are less likely to have a full-term delivery than women without a history of breast cancer.

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Data availability

The data that support the findings of this study are available from the NHIS but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the NHIS.

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Acknowledgements

This work was supported by the Korean Breast Cancer Society and the Study of Multi-disciplinARy Teamwork for breast cancer survivorSHIP (SMARTSHIP). This study enrolled patients from the National Health Information Database (NHIS-2017-4-011), which was provided and is maintained by the National Health Insurance Service (NHIS). The authors would like to thank the National Health Insurance Service for cooperation.

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Authors and Affiliations

  1. Department of Surgery, Catholic Kwandong University International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro 100 beon-gil, Seo-gu, Incheon, 22711, Republic of Korea

    Hak Min Lee & Ilkyun Lee

  2. Department of Obstetrics and Gynecology, Catholic Kwandong University International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea

    Bo Wook Kim

  3. Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Seho Park

  4. Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea

    Sungmin Park & Young Jin Choi

  5. Department of Surgery, Samsung Medical Center, Seoul, South Korea

    Jeon Eon Lee

  6. Department of Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, South Korea

    Sung Yong Kim

  7. Department of Surgery, Korea University College of Medicine, Seoul, South Korea

    Sang Uk Woo

  8. Department of Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, Republic of Korea

    Hyun Jo Youn

Authors
  1. Hak Min Lee
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  2. Bo Wook Kim
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  3. Seho Park
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  4. Sungmin Park
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  5. Jeon Eon Lee
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  6. Young Jin Choi
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  7. Sung Yong Kim
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  8. Sang Uk Woo
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  9. Hyun Jo Youn
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  10. Ilkyun Lee
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Corresponding authors

Correspondence to Hyun Jo Youn or Ilkyun Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The authors declare that the present study complies with the current laws of Korea, and this study was approved by the Institutional Review Board of Catholic Kwandong University International St. Mary’s Hospital (IS16RCMI0053).

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Lee, H.M., Kim, B.W., Park, S. et al. Childbirth in young Korean women with previously treated breast cancer: The SMARTSHIP study. Breast Cancer Res Treat 176, 419–427 (2019). https://doi.org/10.1007/s10549-019-05244-6

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  • DOI: https://doi.org/10.1007/s10549-019-05244-6

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