Many young women diagnosed with breast cancer face a daunting question: Will they be able to conceive after undergoing treatment? The fear of infertility often looms large, especially given the harsh effects of cancer therapies on reproductive health.
However, a new study offers a beacon of hope, suggesting that a significant majority of women under 40 who battle breast cancer can indeed achieve pregnancy post-treatment.
Hope for Future Pregnancies
The study tracked 197 breast cancer survivors who were, on average, 32 years old at the time of diagnosis. All participants had been diagnosed with early-stage or locally advanced breast cancer that had not metastasized. The study aimed to determine the likelihood of these women conceiving after their cancer treatment.
Over a follow-up period of approximately 11 years, the findings were promising: 73% of the participants successfully became pregnant at least once, and 65% of them experienced at least one live birth. These results were presented at the annual meeting of the American Society of Clinical Oncology (ASCO).
“For many young women with breast cancer, the ability to have children following treatment is a major concern,” said the lead study author, Kimia Sorouri, MD, MPH, of the Dana-Farber Cancer Institute, in a statement.
“The findings of our study can be helpful when counseling patients about fertility issues. The finding that egg/embryo freezing before treatment was associated with a higher live birth rate underscores the need for accessibility to fertility preservation services for this population,” she said.
The Role of Fertility Preservation
One of the key takeaways from the study was the significant impact of fertility preservation methods on the ability to conceive after treatment. About half of the women in the study became pregnant within four years of their diagnosis.
The study found that younger women and those who could access and afford fertility preservation at the time of diagnosis were more likely to conceive. Fertility preservation typically involves freezing eggs or embryos before cancer treatment begins, ensuring the possibility of future pregnancies.
Cancer Type and Conception Odds
The study focused on women with less-aggressive forms of breast cancer, ranging from stage 0, where tumors are small and noninvasive, to stage 3, where cancer has spread to the lymph nosed.
Interestingly, the research indicated that several factors did not significantly influence the likelihood of conception or childbirth. These factors included a history of infertility, the specific type of cancer treatment received, genetic cancer risk, and the participants’ race or ethnicity.
Impact of Cancer Treatment on Fertility
Ann Partridge, MD, MPH, an oncologist at Dana-Farber Cancer Institute and a professor at Harvard Medical School, who is also the senior author of the study, discussed the dual impact of breast cancer diagnosis and treatment on fertility.
“Chemotherapy, which is given to the majority of young breast cancer patients, can impair ovarian function and associated fertility, both temporarily and in the long term,” Dr. Partridge explained. She also noted that chemotherapy can pose risks to a fetus if a woman becomes pregnant while the drugs are still active in her system.
Moreover, the potential for cancer recurrence, particularly in the first couple of years post-diagnosis, often leads doctors to advise patients to delay pregnancy for at least a year. This waiting period can be stressful, as it coincides with the natural decline in fertility that occurs with age.
There is a Natural Decline in Fertility As Women Age
“During this time, which sometimes is a number of years, fertility is naturally declining with age,” Dr. Partridge emphasized.
The findings highlight the critical need for early referrals to fertility preservation services for young women diagnosed with breast cancer. This is particularly vital when oncologists anticipate the need for chemotherapy or adjuvant therapy with drugs like tamoxifen, which is used to prevent cancer recurrence after the initial treatment.
Kutluk Oktay, MD, PhD, a professor at Yale University and the medical director of the Innovation Institution for Fertility Preservation and Reproductive Sciences, stressed the importance of initiating fertility preservation procedures as early as possible.
“They should do that as early as possible in the process because it takes some time to set up the fertility procedures,” says Dr. Oktay, who wasn’t involved in the new study.
A Positive Outlook for Breast Cancer Survivors
The study’s results provide a reassuring outlook for young breast cancer survivors who hope to start or expand their families.
“The majority of women who want to become pregnant can become pregnant, and those pregnancies usually result in a live birth. We are getting better at speaking with patients at diagnosis regarding this important survivorship issue and, if women are at higher risk of becoming less fertile with treatment, at supporting patients to pursue fertility preservation at diagnosis so they can become pregnant later in their survivorship,” Dr. Partridge says.
Fertility After Breast Cancer is Possible
For young women diagnosed with breast cancer, the possibility of becoming a mother after treatment is a significant concern. This study offers encouraging news, showing that many women can conceive and have healthy pregnancies after overcoming breast cancer. It also highlights the importance of early access to fertility preservation services, which can greatly increase the importance of early access to fertility preservation services, which can greatly increase the chances of successful and conception and childbirth later in life.
The ongoing advancements in cancer treatment and fertility preservation continue to bring hope to young women facing the dual challenges of cancer and future family planning.
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