Q&A on fertility and motherhood in breast cancer survivors

Q&A on fertility and motherhood in breast cancer survivors

Q&A on fertility and motherhood in breast cancer survivors

Most breast cancers are found in women aged 50 and above. Of late, the incidence of breast cancer is increasing in younger age groups. Treating this cohort has its unique challenge – balancing the disease from coming back with fertility issues and pregnancy.

There are many instances of women achieving pregnancy after undergoing therapy for breast cancer. However, certain treatments can make it harder to achieve pregnancy. Young breast cancer survivors if planning to conceive in future or just wish to keep one’s options open, the best time to talk to your doctor is before you begin breast cancer treatment.

Can I plan for pregnancy after completion of my breast cancer treatment ?

Yes. Some treatments like chemotherapy for breast cancer can damage the ovaries, causing immediate or delayed infertility. Still, many women can become pregnant after treatment and motherhood is possible!!

Does pregnancy or breastfeeding increase breast cancer recurrence?

Many breast cancers are sensitive to estrogen, so there has been concern that for women who have had breast cancer, the high hormone levels that result from pregnancy might increase the chance of the cancer coming back. Sound research data promulgates that risk of cancer recurrence at time of pregnancy is minimal.

Some women who are on hormonal therapy might not be able to breastfeed after breast cancer treatment, but for those who are able to, breastfeeding after treatment do not increase the risk of breast cancer recurrence. Breastfeeding (especially for a year or more) reduces the risk of developing breast cancer, although there is scanty evidence whether it can help reduce the risk of breast cancer coming back in cancer survivors. 

How long should I wait after breast cancer therapy before getting pregnant?

Breast cancer survivors who want to become pregnant are advised to wait for at least 2 years after the treatment, to note for early recurrence.

This waiting period of 2 years is not based on data from any clinical trials and some breast cancers can recur after the 2-year mark, so every case is unique. Your decision should consider many things like your age, stage of cancer, type of breast cancer, and the risk of the cancer coming back early which you must discuss in detail with your doctor.

Is my history of breast cancer going to put my baby at risk if I get pregnant?

A history of breast cancer appears to be associated with an increased risk of various pregnancy issues, like preterm delivery, having a low-birth-weight baby, and the requirement for a caesarean surgery (C-section).

But research has found that there is no increased rate of birth defects or other long-term health concerns in children born to women who had breast cancer.

Does breast cancer treatment affect my unborn baby?

If you are still getting any type of treatment for breast cancer, including chemotherapy, hormone therapy or targeted therapy talk to your doctor before trying to become pregnant. Most of these therapies can harm a fetus, hence it is advised to complete entire treatment and then to plan for pregnancy. It is important to realize that treatment defaulters incur the risk of cancer spread and recurrence.

Can I breastfeed after breast cancer treatment?

If you have undergone breast surgery and radiation, you might have problems breastfeeding from the affected breast like decreased milk production in that breast as well as structural changes that can make breastfeeding painful and latching difficult. However, many breast cancer survivors had successfully breast fed their babies. If you are still receiving hormonal therapy for your breast cancer, it is important that you consult with your doctor before attempting to breastfeed as these medicines can enter breast milk and harm the baby.

For young breast cancer survivors, planning parenthood is an informed decision making with an oncologist. Consult with your doctor for thorough understanding of your unique situation and availing fertility-sparing options like oocyte or embryo cryopreservation before starting cancer treatment. Parenthood after breast cancer is possible, with proper guidance and a well- informed approach.



Dr. Y Rajani Priya,
Medical Oncologist
Mahatma Gandhi Cancer Hospital and Research Institute, Visakhapatnam