Breast cancer treatments can put a wrench in your plans to start a family. But now, there’s hope for people who’ve had treatment and who want to have a baby.
A new study presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting found most young women with early-stage breast cancer can become pregnant and give birth after they finish treatment. And those who have fertility procedures to freeze their eggs before treatment have the most success.
“A lot of breast cancer patients worry about what their future may hold in terms of family planning, and this is a very important and encouraging study for them,” says Marla Lipsyc-Sharf , MD, a breast medical oncologist at UCLA David Geffen School of Medicine.
Why Is Fertility a Concern if You Have Breast Cancer?
Treatments for breast cancer, like chemotherapy and hormone therapy, can make you less able to get pregnant. That’s because they may stop your ovaries from working the way they should. These therapies can also shorten the window of time you’re able to have children. You can’t get pregnant while you take them, and you might have to wait a little while after you stop chemo.
There’s a lot to think about if you want to get pregnant after breast cancer treatment. For one, you might wonder if it’s even safe for you and your baby. But pregnancy after breast cancer is not linked to worse survival for women.
You may also worry that you’ll pass an inherited gene down to your child. Or you might be concerned that you won’t be able to breastfeed. Many women also fear that their cancer could come back while their children are young.
Research shows more young women have to face these tough situations. Today, more than 250,000 people in the U.S. were diagnosed with breast cancer when they were younger than 40. And breast cancer diagnoses in women under age 50 rose by more than 2% each year over the past 5 years.
“So, we have this increase in the number of breast cancers diagnosed in young patients, and we’re also seeing pregnancy delayed in young women, and that’s why fertility after a breast cancer diagnosis is becoming a lot more common of an issue,” Lipsyc-Sharf says.
What Were the Key Results of the Study?
The study presented at ASCO included almost 200 women who were younger than age 40 and wanted to get pregnant. The women all had stage 0, stage I, stage II, or stage III breast cancer.
Patients with advanced breast cancer that had spread to distant parts of the body and those who had a hysterectomy (surgery to remove a woman’s uterus) were not included in the study. About 15% of the women in the study said they had fertility problems before they found out they had breast cancer. Researchers followed the people in the study for an average of 11 years.
In her presentation, lead author Kimia Sorouri, MD, MPH, from the Dana-Farber Cancer Institute, noted that previous studies have only included women with certain types of breast cancer. The past trials also followed them for just a short amount of time. And they only asked women if they tried to get pregnant, not if they actually did.
This new study aimed to fill those gaps. Researchers followed the women for a longer period of time, included different types of breast cancer, and recorded pregnancies and live births.
“I think this study was done extremely well,” Lipsyc-Sharf says. “The researchers had a very long follow-up time, which is something patients are always concerned about. They always want to know that people are looking at more than 5 years out.”
This new research found:
- Most of the people who tried to get pregnant did. In fact, 73% of the women in the study reported one or more pregnancies, and 65% gave birth successfully.
- The time from diagnosis to pregnancy ranged from about 6 months to about 10 years.
- About 28% of the women in the study had a fertility preservation procedure before they started their cancer treatment. These methods included freezing eggs or embryos.
- The women who had fertility preservation procedures were more likely to give birth than those who didn’t have them.
- Older women had lower rates of pregnancy and live births, compared to younger women in the study.
- Women who reported being more “financially comfortable” were more likely to get pregnant.
- The stage of a woman’s breast cancer did not affect her ability to become pregnant or have a baby.
What Do the Results Mean for Breast Cancer Survivors?
The findings from this study suggest that most women who want to have a baby after breast cancer are able to, especially if they freeze their eggs or embryos before treatment.
“Importantly, this [research] highlights the need for increased accessibility of fertility preservation services for women newly diagnosed with breast cancer who are interested in future pregnancy,” Sorouri said in her presentation.
The most common way to preserve fertility is to freeze and store your eggs or embryos before you start treatment. You may take an ovarian suppression medicine, which helps protect your ovaries from damage during chemo.
About half of younger women with breast cancer report that they are worried about infertility due to treatment. Yet, a recent study published in Cancer Medicine found only 20% of young patients with breast cancer who have concerns actually pursue fertility preservation.
The cost is one reason some patients don’t give these methods a try. A single round of egg or embryo freezing can run up to $15,000. But you should check your insurance plan to see if they are covered.
Other things, like a lack of resources or access to counseling services, may play a role. Also, the decision to have fertility preservation has to be made relatively quickly after a diagnosis. This can add another layer of anxiety for some women who are also trying to emotionally deal with a cancer diagnosis.
Experts say doctors and patients should try to address these issues as much as possible. Psychological counseling before treatment is one way that could help breast cancer survivors make an informed decision.
“Fertility is something that is unfortunately considered after the fact, but it should be something that should be discussed up front,” Lipsyc-Sharf says. “The main takeaway from this study should be that a woman should speak with her oncologist as soon as possible regarding her desire for future planning.”
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SOURCES:
Marla Lipsyc-Sharf, MD, breast medical oncologist, UCLA David Geffen School of Medicine.
2024 American Society of Clinical Oncology (ASCO) Annual Meeting: “Abstract 1518.”
Susan G. Komen: “Having Children After Breast Cancer.”
Cancer Research UK: “Women's fertility and chemotherapy.”
Young Survival Coalition: “Breast Cancer Statistics in Young Adults.”
Breast Cancer Research Foundation: “5 Facts About Breast Cancer in Younger Women.”
Cancer Medicine: “Fertility concerns and treatment decision-making among national sample of young women with breast cancer.”
Journal of Psychosocial Oncology: “Psychological Counseling of Female Fertility Preservation Patients.”
