However, there are still no solid answers as to the risk in pregnancy after breast cancer treatment.
Waiting period advised
Breast cancer is relatively rare in young women; more than three-quarters of cases occur in women over age 50. As improved treatments help more young women survive breast cancer, the question of whether to have a child later becomes increasingly important.
Indeed, many doctors still advise a waiting period. Patients are usually told to wait two years if they have negative [lymph] nodes, and five years if they have positive nodes, so that the really aggressive disease will become known before they get pregnant.
Factors to consider
Although few studies have been done, none have found evidence that pregnancy after successful breast cancer treatment increases the risk of the disease coming back. But as breast cancer is strongly influenced by hormones, the changing hormonal levels during pregnancy could have some effect on a woman who has already had the disease.
Further research is also needed to determine what risk pregnancy may pose to breast cancer survivors, and if that risk is influenced by factors like age, race or disease characteristics.
Careful consideration critical
The decision for breast cancer survivors who are thinking about getting pregnant is a very complex and personal one.
Breast cancer survivors who need to discuss the issue thoroughly with their families and their doctors. Women should talk to their doctors about:
- Their breast cancer prognosis – including the chance of having a recurrence.
- The appropriate duration of the waiting period to prevent the risk of relapse.
- Other related health problems such as heart damage from chemotherapy drugs that could be exacerbated by pregnancy.
- Managing breast cancer if it were to return.
Other relevant issues
- Fear of recurrence or dying and its effect on caring for a child. Some women may not want to risk becoming pregnant when they may not live long enough to raise the child. Others, however, may believe that, even if they do die while their child is young, they will be able to give their child the love and care it needs to grow up to be a well-adjusted adult.
- Passing on family traits. Some breast cancer survivors with a strong family history of the disease may not want to pass on a potentially high risk of cancer to future generations. Others may feel very positive about passing on a range of family traits and believe that a child deserves the chance to enjoy life even if the child may, as an adult, face the possibility of illness.
- Going through early menopause. Another important issue for survivors to consider is the potential for early menopause. Caused by chemotherapy, early menopause essentially ends a woman’s chance for a natural pregnancy and childbirth. The closer a woman is to her natural menopause, the more likely it is that chemotherapy will hasten menopause.
- Breastfeeding. Certain treatments for breast cancer can have an impact on a woman’s ability to breastfeed. For women who have had a mastectomy or breast conserving surgery plus radiation, breastfeeding from the untreated breast should be relatively normal. More problematic is feeding from the treated breast following breast conserving surgery plus radiation. Both the surgery and radiation therapy can harm tissue that is critical to breastfeeding. While studies show that feeding from the treated breast is possible (and that the milk produced is safe for the infant), they also show that it is uncommon.