Early Breast Cancer: Will Treatments Affect My Chances To Get Pregnant?

A young patient in her 30s was recently diagnosed with early breast cancer (stage 2). She was not keen for further adjuvant treatment as she was worried that it might affect her fertility and chances to get pregnant. She didn’t even ask if it was safe for her to omit adjuvant treatment.

There is one study (Gelber, 2001) that look into fertility and safety issues after diagnosis and treatment of early breast cancer.

FERTILITY

In that study:

  • The average age of patients with early breast cancer in that study was 31 years old
  • 67 out of 94 patients with early breast cancer became pregnant after diagnosis and completion of treatment (some pregnant more than one time)
  • Resulting in 137 pregnancies and 91 live birth, 33 abortions, 13 miscarriage.
  • Average time to get pregnant (from diagnosis to completion of first pregnancy) was 27.8 months
Screen Shot 2018-05-23 at 2.16.38 PM
Forty-three percent of the women completed their pregnancy (birth or abortion) within 2 years of their diagnosis

Amongst the 94 patients in the study:

  • 63 patients (68%) had mastectomy surgery
  • 26 patients (28%) had radiation therapy
  • 55 patients (59%) had adjuvant chemotherapy
  • 3 patients (3%) had hormonal therapy (many women were diagnosed before the routine assessment of ER and PgR)

The above showed that despite treatment(s) for breast cancer, patients will still be able to get pregnant. I’m actually more surprise that almost 1/5 of them managed to get pregnant in the first year because total duration of surgery, chemotherapy and radiation therapy (if required) normally takes about 6-8 months.

Contraception is strongly advised during breast cancer treatment(s) as chemotherapy is not safe during first trimester, targeted therapy and radiation therapy is not safe throughout pregnancy.

SAFETY

The study also also shed some surprising information on the benefit of pregnancy for patients with early breast cancer (see image below).

Screen Shot 2018-05-23 at 2.17.18 PM.png
Survival of the women who became pregnant was superior to the matched group. 5-yr survival was 92% vs 85% and 10-yr survival 86% vs 74%

Other than this study, there are also few studies which point to the protective effect of pregnancy to patients with early breast cancer. Consistently, those studies  showed that the risk of death was halved Some even showed halving the risk of death.

In summary, pregnancy is possible and beneficial for patients with early breast cancer after completion of all curative treatments.

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