October is Breast Cancer Awareness Month, which makes it a good time to start talking about how it can affect potential mums. Approximately 12% of women in the U.K. contract breast cancer, with about 20% of the diagnosed under the age of 50. There is a not an insignificant incidence of breast cancer in women of childbearing age, or who are already pregnant, and you may be wondering how it may affect you and your chances of becoming pregnant.
To clarify the risks that breast cancer poses, and what you can do to counter them, I’ve done some research and put together a short guide to the most common questions faced by women who are battling cancer and want to have children.
I have linked to my resources at the bottom of this post if you want to do further reading and speak to a professional about your personal circumstances.
1. Will breast cancer make me infertile?
This is one of the most common concerns of young women regarding breast cancer. The cancer itself does not affect fertility, but the treatment may. There are 3 main factors that determine whether your fertility will be affected: age, stage of cancer at diagnosis, type of treatment.
At the age of 30, a woman’s fertility starts decreasing. The older you are, the more likely your fertility will be affected. Treatment can actually induce menopause, especially for women over the age of 40.
ii. type & stage of the cancer
The stage of the cancer at the time of diagnosis may determine whether you need chemotherapy. The type of cancer will also have an effect. Small, localised tumors can be surgically removed. Invasive, advanced cancers typically need to be treated with chemotherapy. Chemotherapy has a significant impact on fertility.
iii. treatment type
Chemotherapy drastically raises the risk of ovarian failure or very early menopause. Experts estimate that 4 out of 5 women treated with chemotherapy develop ovarian failure. There are particular varieties of chemotherapy which provide a higher risk than others.
Cancers that can be treated with surgery and radiation will not affect fertility.
Ask your doctor for information on your particular treatment options and how they will affect your fertility.
2. What can I do to preserve my fertility?
As things stand, there is only one proven method for women with breast cancer to preserve fertility: IVF (in vitro fertilisation).
Hormones are taken to stimulate the ovaries to make more eggs.
Eggs are removed and fertilised with sperm from your partner or a donor.
This creates an embryo, which is frozen, and can be inserted in the womb when you decide to become pregnant at a later stage.
There are a number of downsides to the procedure:
a. hormones may affect the development of the cancer, by stimulating breast cancer cells to grow
b. treatment of the cancer might have to be delayed by 3 to 4 weeks while the process is completed
c. you may not have a partner or donor from whom to collect sperm as yet
However, other options of preserving fertility are limited. A procedure called “natural IVF”, in which doctors collect eggs during the woman’s menstrual cycle, is being tested, but has not shown any major results as yet.
Another procedure – in which ovarian tissue is surgically removed and frozen, to be put back after the cancer treatment – is also being tested. Thus far, it has shown encouraging results.
3. Should I wait after recovery before attempting to become pregnant?
The hormonal changes caused by pregnancy may have an effect on your chances of contracting breast cancer. As relapse is most common during the first 2 years after recovery, it is recommended to wait until that time period has lapsed before attempting to become pregnant.
4. Will my baby carry a higher risk of breast cancer?
Many women with breast cancer worry that by having their own children, they are risking passing on a genetic inheritance of the disease. However, the statistics show little cause for concern.
Only 5% of breast cancers are caused by a genetic mutation, and there is only a 1 in 2 chance that those genes will be inherited by the child.
There is no evidence that offspring of breast cancer survivors have a higher chance of childhood cancers.
5. Pregnant when diagnosed: will chemotherapy harm my baby?
Chemotherapy has been shown to have little effect on unborn fetuses during the 2nd and 3rd trimesters. In a study of 70 children exposed to chemotherapy in the womb, no significant developmental deficiencies were found. IQ scores, however, were lower in children born prematurely, but that is believed to be correlated to early birth, rather than the chemotherapy itself.
In the 1st trimester, chemotherapy should be avoided, as it carries a higher risk of causing birth defects.
6. Can I use contraception after recovery?
Use of birth control pills after recovery from breast cancer is considered unsafe, as they cause high levels of hormones which increase the chance of relapse. Doctors recommend using condoms, diaphragms, or a non-hormonal I.U.D.
7. Can men get breast cancer?
Men can get breast cancer, but it is very rare. Fertility in men is affected by breast cancer. Freezing sperm is a very effective means of preserving fertility.
I hope this has provided you with valuable information on how breast cancer can affect women of childbearing age.
I encourage you to do further research, either at your local health clinic or at the following sites:
Cancer Research UK