A breast cancer diagnosis can unfortunately come at any age. For younger women in particular, who may be considering starting a family or having more children, this can also raise concerns about how their treatment could affect their reproductive health. Luckily, medicine is advancing and giving women diagnosed with breast cancer more options about the future of their reproductive health. Some women may have the option to “freeze their eggs” before starting cancer treatments. This allows eggs to be safely “harvested” and frozen for later use.
Treatments like chemotherapy can also bring on earlier menopause. In some cases, this effect is temporary and is reversed once treatment is over. This is also known as chemotherapy-induced amenorrhea. The risk of amenorrhea after taxane chemotherapy like Taxol or Taxetere, or Anthracycline chemotherapies like Adriamycin (chemical name: doxorubicin), AKA the Red Devil, account for 21-71% in young women, and 49-100% in those over 40 years of age according to Pourali et al.
"Studies show that getting pregnant does not seem to make cancer return. Some health care providers advise breast cancer survivors to wait 2 years before trying to get pregnant. There is a link between some hormones that rise during pregnancy and the growth of breast cancer cells. But there is no scientific proof that cancer risk increases if a woman gets pregnant within 2 years of completing treatment" (Cancer.net).
If you've been diagnosed with breast cancer and are considering your options for family planning, here are some questions to keep on hand when speaking with your cancer care oncology team:
Will my cancer treatment plan affect my ability to have children?
Are there ways to preserve my fertility before I start treatment?
Will my treatment plan cause problems during pregnancy, labor, or delivery?
How long should I wait before trying to have a child?
How will trying to have a child affect my follow-up care plan?
Will trying to have a child increase my risk of recurrence? (Source: Cancer.net)
Podcast Episode #114. Triple Positive Breast Cancer Under 30
In this episode, Tabby shared her experience of being diagnosed in her 20's, including the fertility options she explored. Listen Now.
Breast Cancer Stories
Rayna found the lump in her breast two months after having her daughter. She shared that she experienced early menopause at age 31. Two years after treatment, her period still hasn't come back. "My daughter is the best thing that’s ever happened to me, and if I can’t have another child, I’m okay with that." Read More.
#106. Fertility Preservation Before
Jessica was diagnosed with breast cancer at the age of 32. She was focused on her career, living on her own, and totally unprepared for what was ahead. Like so many of us faced with rapid fire decisions, we don't necessarily have time to research and learn about what options are available. Today we take a deep dive into the topic of fertility and breast cancer. Listen Now
#50 - Egg Retrieval at 6am. 1st Chemo at 11am | Interview with Caitlin Edmonds, TNBC
Caitlin Edmunds discusses her cancer diagnosis and the various challenges she had to overcome. She talks about getting a second opinion on her diagnosis, her experience with egg retrieval, and her chemotherapy treatment.
Content Across The Web
Some breast cancer treatments can bring on menopause earlier than it naturally would occur. This is known as medical menopause, which can be caused by chemotherapy, or surgical menopause when the ovaries are surgically removed. Surgical menopause is a permanent change, but when caused by chemotherapy, this is sometimes a temporary state during the treatment which resolves once chemotherapy has been completed. “With medical and surgical menopause, the ovaries stop functioning and hormone levels fall right away (surgical menopause) or over a period of weeks or months (medical menopause) — not over a few years, as usually happens with natural menopause. The suddenness of surgical menopause can cause intense symptoms for younger premenopausal women.” Some chemotherapy drugs are more likely than others to cause medical menopause. Read on for more details. Read More.
“Because of potential harmful effects in the fetus, you will need to be very careful not to become pregnant while on tamoxifen. Also, a fact not widely known is that tamoxifen was initially developed as a fertility drug. Therefore, even if you are not menstruating regularly, you can still become pregnant while taking this drug and it is important that you and your partner use a non-hormonal form of birth control. If you suspect you may be pregnant or if you want to become pregnant, make sure you discuss this with your doctors.”
Although the data are limited, there is currently no evidence to suggest that pregnancy after breast cancer increases your chance of recurrence. It is often recommended to wait a few years after the completion of all treatment (this includes tamoxifen) to allow your body to recuperate. Read More.
“The practice of fertility preservation (FP) in women with breast cancer (BC) is spreading, but long-term reproductive outcomes after FP are largely unknown.” This 2020 study out of Sweden compared the reproductive outcomes in women who did or did not undergo FP at the time of diagnosis. Using national databases, they examined outcomes of live births, assisted reproductive technology (ART) use, and mortality. The study found that successful pregnancy was possible among both women with and without FP, but women who had used fertility preservation had a higher likelihood of live births. Read More.
“Your options for fertility preservation and growing your family depend greatly on where you are in your course of treatment and what steps you’ve already taken. The good news is that there’s more information than ever for young breast cancer survivors interested in having children.” A few important things to remember:
It can take over a year for your period to return.
Your period doesn’t necessarily indicate fertility. Regular periods are good but don’t definitely mean you can get pregnant. On the other hand, absent periods don’t always mean you can't get pregnant.
If your doctor confirms you are infertile, there are still other options for parenthood.