Today, more and more women are surviving breast cancer, which means more and more are concerned about what life after treatment looks like. It’s a problem created by our own success — because more women are surviving, we’re now looking for ways to support them as they get back to their lives post-cancer.
Fighting cancer is difficult, but adjusting to life after cancer can be nearly as hard. All of a sudden, your life no longer revolves around the disease — now what? For many young women, their attention turns to having children.
When it comes to pregnancy after breast cancer, many have concerns as they begin to refocus on growing their family and looking toward the future. These are a few of the questions I often hear from patients and families in this stage of life.
Is it safe to have a baby after breast cancer?
Studies have shown that it is in fact safe to have a baby after breast cancer treatment. Two recent studies in particular concluded that pregnancy and childbirth do not impair a woman’s survival after breast cancer.
- A retrospective, multi-center trial from Europe was recently presented at the 2017 American Society of Clinical Oncology meeting, evaluating the safety of pregnancy after breast cancer treatment. This study included 1207 patients, 333 of whom were pregnant compared with 874 who were not. After a median follow-up of 10 years, there were no differences in survival rates between the two groups.
- Another retrospective, observational study from the Ontario Cancer Registry in Canada evaluated the effect of pregnancy on the outcomes of women diagnosed with breast cancer. After a median follow-up of five years, those who became pregnant after breast cancer treatment actually had a higher five-year survival rate than those who did not become pregnant. It is possible that the better outcomes may be partially due to the “healthy mother” effect because women who become pregnant are typically healthy and may be more likely to live longer. Nevertheless, this study illustrates that pregnancy does not have a negative effect on women’s health and survival rates after breast cancer treatment.
For young women who face a breast cancer diagnosis early in life, these studies can help give you confidence as you move on to the next phase of your life.
Is it harder to get pregnant after breast cancer?
Fortunately, most women who are young when they go through chemotherapy do not have issues with fertility. But about 10 percent of patients find that their fertility does not return after treatment ends.
For women concerned about fertility, there are options. Some women choose to shut down their ovaries with medicine, which allows them to receive chemotherapy treatments without affecting the ovaries. Others choose to harvest their eggs prior to treatment. It only takes two weeks to complete this process, which makes it possible for women to harvest their eggs before beginning chemotherapy.
There are several options for women concerned about becoming pregnant after they finish treatment — talk to your doctor about which option might be right for you.
Some women have to have their ovaries removed, particularly patients with the BRCA1 or BRCA2 genetic mutations. Some of these young women choose to cryopreserve their ovaries or some of their eggs, and can even preselect them for the ones that don’t have the mutation.
How long should you wait after finishing treatment to have a baby?
Normally, I suggest waiting two years, but it may depend on what kind of treatment you are on. This two-year window is referred to as the “disease interval,” in which we might anticipate a recurrence of the disease. Once you pass that mark, experts consider it safe to become pregnant.
Can you breastfeed after treatment and surgery?
Usually, the cancerous breast has been treated with radiation, so most of the time that side cannot breastfeed, unless it’s been a very long time since the treatment finished. However, the other breast is still an option as a way to safely breastfeed, as long as the milk production is enough.
What if you’re pregnant when you’re diagnosed with breast cancer?
Women who are pregnant when they are diagnosed with breast cancer can undergo chemotherapy treatments and surgery. We avoid some chemotherapy agents that cross the placenta, but most of the active drugs given for breast cancer can be given safely without harm to the unborn child. Surgery is also safe in the second and third trimesters of the pregnancy. On the other hand, we do avoid anti-estrogen and radiation treatments until after the baby has been delivered.
About 250,000 women are diagnosed with breast cancer every year. Since the average age for a breast cancer diagnosis is around 60, most of these women are past childbearing age. However, for the roughly 26,000 women diagnosed with breast cancer who are 45 years and under, pregnancy quickly becomes a concern.
If you have been diagnosed with breast cancer and have questions about pregnancy, I’d advise you to talk to your doctor and figure out what your options are moving forward.