Pregnancy after Breast Cancer
Can you get pregnant after having breast cancer?
Yes! However, you’ll need to plan for it and take the necessary steps before your cancer treatment. You should talk about your intention to get pregnant with your healthcare providers. They will consider it in your treatment plan and guide you through the process. For instance, they may suggest strategies to preserve your eggs before treatment.
The McGill University Health Centre (MUHC) set up the Fertility Preservation Awareness Program to improve cancer patients’ chances of having a child after treatment. A team is establishing processes to ensure that oncologists discuss fertility at the first appointment and to implement the egg preservation process quickly. This Rossy Cancer Network project aims to facilitate access to specialized fertility care and educate patients about the possibilities. For more information, please visit their website: https://www.mcgill.ca/rcr-rcn/press-room/kids-after-cancer-it-possible
A history of breast cancer may increase your chances of a premature and low birth weight baby. Appropriate follow-up and prevention will therefore be required.
Breast cancer treatment can decrease fertility
Because age is a significant risk factor for recurrence, women aged 35 and younger with a diagnosis of breast cancer often receive chemotherapy to limit the chances of the disease recurring. Unfortunately, chemotherapy can decrease fertility or even cause early menopause. Chemotherapeutic agents can cause anovulatory cycles (without ovulation) or transient or permanent amenorrhea (lack of menstruation). These irregularities are common, but menstruation most often recovers within the 6 to 24 months after treatment. The risks of diminished fertility vary from one woman to the next, depending on age and the chemotherapy type and dose.
Your healthcare team will evaluate various factors and advise you about how long to wait before getting pregnant, depending on your initial stage of cancer, risk of recurrence, type of treatment received, prognosis and age. If you are taking hormone therapy, they will also assess your risk of stopping Tamoxifen prematurely to allow pregnancy.
A minimum of six months following treatment is recommended before pregnancy to allow the body to evacuate the eggs damaged by the treatment. After hormone therapy, however, it is preferable to wait five years before conceiving a child.
Does pregnancy increase the risk of cancer recurrence?
Women are often concerned that pregnancy will increase the risk of cancer recurrence. Some worry that the high estrogen levels present during pregnancy could activate any cancer cells the treatment didn’t eliminate. Also, women with cancers expressing ER and RA receptors usually take hormone therapy for a few years to decrease their risk of recurrence. The necessary suspension of treatment during pregnancy is another source of concern.
However, the data are reassuring about the risk of recurrence caused by pregnancy. A recent study involving 1,200 women showed that a pregnancy following breast cancer remission does not increase the chances of recurrence. https://www.asco.org/about-asco/press-center/news-releases/pregnancy-after-breast-cancer-does-not-increase-chance
You should discuss the length of the wait between the end of treatment and the pregnancy with your doctor. The decision of whether to get pregnant depends on each woman’s risk of recurrence and whether she is taking adjuvant hormone therapy.