Racial Differences in Live-Birth Outcomes After a Breast Cancer Diagnosis

Breast cancer is the most common cancer among young women, and its treatment can compromise future fertility. Although racial and ethnic disparities are well established in cancer outcomes, their effect on postcancer fertility is not well understood. We evaluated racial and ethnic differences in live-birth rates between women diagnosed with breast cancer compared with the general population using linked data from California and the National Center for Health Statistics bridged-race population estimates. Among 25,448 women aged 20-49 diagnosed with stage I-III breast cancer between 2000 and 2012, breast cancer was associated with a 58% reduction in live-birth rate compared with women without cancer (birth-rate ratio 0.42; 95% CI, 0.39-0.47). Reductions varied by race and ethnicity: 61% in non-Hispanic White, 50% in non-Hispanic Black, and 32% in Hispanic women. Non-Hispanic Asian women had increased fertility (birth-rate ratio 2.21; 95% CI, 1.90-2.58). These findings highlight racial differences in reproductive outcomes after breast cancer underscoring the need for further research to identify contributing factors.