Беременность после лечения рака молочной железы: современный анализ сроков планирования и возможностей лактации у пациенток с различными молекулярными подтипами

Daria Glebovna Ulrikh; Elena Konstantinovna Zhiltsova; Olga Evgenievna Lavrinovich; Evgenia Alexandrovna Kalinina; Yulia Andreevna Chekina; Mark Mikhailovich Remizov; Viacheslav Yurievich Khalturin; Zhanna Victorovna Bryantseva; Elena Alexandrovna Ulrikh; Petr Vladimirovich Krivorotko

doi:10.37469/0507-3758-2026-72-3-OF-2690

Vol. 72 No. 3 (2026), ORIGINAL ARTICLES. CLINICAL RESEARCH

Vol. 72 No. 3 (2026)

Pregnancy After Breast Cancer Treatment: A Contemporary Analysis of Timing and Lactation Possibilities in Patients with Different Molecular Subtypes

ORIGINAL ARTICLES. CLINICAL RESEARCH

https://doi.org/10.37469/0507-3758-2026-72-3-OF-2690

Published 03.07.2026

Daria Glebovna Ulrikh

N.N. Petrov National Medical Research Center of Oncology, Federal State Budgetary Educational Institution of Higher Education North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian Federation

https://orcid.org/0000-0002-1346-933X

Elena Konstantinovna Zhiltsova

N.N. Petrov National Medical Research Center of Oncology

https://orcid.org/0000-0002-2029-4582

Olga Evgenievna Lavrinovich

N.N. Petrov National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

https://orcid.org/0000-0002-1886-3993

Evgenia Alexandrovna Kalinina

Almazov National Medical Research Center of the Ministry of Health of the Russian Federation

https://orcid.org/0000-0002-2567-6168

Yulia Andreevna Chekina

Almazov National Medical Research Center of the Ministry of Health of the Russian Federation (Saint Petersburg, Russia)

https://orcid.org/0009-0003-5149-2885

Mark Mikhailovich Remizov

North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of the Russian Federation

https://orcid.org/0009-0008-8242-1461

Viacheslav Yurievich Khalturin

North-Western State Medical University named after I.I. Mechnikov

https://orcid.org/0000-0003-0253-720X

Zhanna Victorovna Bryantseva

N.N. Petrov National Medical Research Center of Oncology

https://orcid.org/0000-0002-9189-6417

Elena Alexandrovna Ulrikh

Almazov National Research Medical Center

https://orcid.org/0000-0002-2701-8812

Petr Vladimirovich Krivorotko

. N.N. Petrov National Medical Research Center of Oncology

https://orcid.org/0000-0002-4898-9159

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Keywords

breast cancer (BC)
pregnancy after breast cancer treatment
fertility
lactation after breast cancer

How to Cite

Ulrikh , D. G., Zhiltsova , E. K., Lavrinovich , O. E., Kalinina , E. A., Chekina , Y. A., Remizov , M. M., Khalturin , V. Y., Bryantseva , Z. V., Ulrikh , E. A., & Krivorotko , P. V. (2026). Pregnancy After Breast Cancer Treatment: A Contemporary Analysis of Timing and Lactation Possibilities in Patients with Different Molecular Subtypes. Voprosy Onkologii, 72(3), OF–2690. https://doi.org/10.37469/0507-3758-2026-72-3-OF-2690

Abstract

Introduction. Breast cancer (BC) remains the most common malignancy among patients of reproductive age. Advances in personalized systemic therapy have led to improved long-term survival, which highlights the issues of fertility preservation, safe pregnancy planning, and lactation in this patient population.

Aim. To systematize current evidence on optimal time intervals for pregnancy initiation and the feasibility of breastfeeding after completion of antitumor treatment in patients with different molecular biological subtypes of BC.

Materials and Methods. A retrospective analysis of clinical and anamnestic data from 25 patients (median follow-up 92.9 months) who achieved reproductive function (2019–2025) after combined and complex treatment for stage I–III BC was performed at the N.N. Petrov National Medical Research Center of Oncology and the V.A. Almazov National Medical Research Center. In addition, a narrative literature review was conducted using the PubMed/MEDLINE, Cochrane Library, ClinicalTrials.gov databases, as well as materials from the SABCS, ASCO, and ESMO congresses (2023–2025).

Results. The mean age at BC diagnosis in the studied cohort was 30.1 ± 4.5 years, and the mean age at pregnancy after treatment was 35.8 ± 3.9 years. Localized forms (stage I–II, 88.0 %) and luminal molecular biological subtypes (64.0 %) predominated. Disease progression was registered in 24.0 % of patients, mainly in those with HER2-positive and triple-negative BC. Breastfeeding was achieved in 72.0 % of patients. Temporary interruption of adjuvant endocrine therapy for up to 2 years is not associated with an increased short-term risk of recurrence. Lactation does not worsen oncological outcomes, including in carriers of germline BRCA mutations.

Conclusion. Current evidence allows for a revision of previously accepted restrictive paradigms: pregnancy after BC treatment is oncologically safe provided that the timing of its initiation is strictly personalized according to the molecular subtype, disease stage, and completed treatment volume. Multidisciplinary management involving an oncologist, reproductive specialist, and obstetrician-gynecologist is mandatory.

https://doi.org/10.37469/0507-3758-2026-72-3-OF-2690

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##article.numberofviews## 344

pdf (Русский)

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