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Breast Cancer Does Not Mean the End of Fertility
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This information has been reviewed and approved by an experienced fertility specialist at Indira IVF to provide accurate and up-to-date guidance for our readers.
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Disclosure
The information provided here serves as a general guide and does not constitute medical advice. We strongly advise consulting a certified fertility expert for professional assessment and personalized treatment recommendations.
Synopsis
How Breast Cancer Treatment Affects Fertility
Breast cancer is the most commonly diagnosed type of cancer in women worldwide. According to the World Health Organisation, around 2.3 million women were diagnosed with breast cancer in 2022, making it a global health concern. While the cancer can affect women of any age group, the risk increases with time. Breast cancer also affects men, but it is more common in women, with 99% of the reported cases being seen in women as opposed to 0.5-1% seen in men.
The relationship between breast cancer and fertility is not direct, as the disease itself does not pose any specific harm to the reproductive system. Instead, it is the treatments that can affect fertility. These treatments include chemotherapy, radiation, and hormonal therapy.
- Chemotherapy: In some cases, certain chemotherapeutic agents, such as alkylating agents, contribute to the acceleration of the depletion of the ovarian reserve and result in premature ovarian insufficiency (POI).
- Radiation: Radiation for breast cancer is usually localised, but scatter radiation may affect the pelvis.
- Hormonal Therapy: Many types of breast cancers have hormone receptors, either ER⁺ or PR⁺, hence requiring treatment with certain drugs for a long time. These drugs are not contraceptives but may affect fertility timing.
Risks Related to Breast Cancer Treatment
Yes, breast cancer treatments can affect fertility in women, but not all methods pose the same risk. The influence of treatment is affected by several factors, such as:
- Type of Chemotherapy: Alkylating agents are relatively more detrimental to ovarian health and are more likely to cause POI than other chemotherapy agents.
- Age: Young women, particularly those aged below 35 years, possess a relatively greater ovarian reserve and therefore may recover effectively from chemotherapy-induced damage.
- Radiation to the pelvis: Pelvic radiation is rare during treatment, but in case it is required, it can significantly affect uterine and ovarian function.
- Duration and dosage: Higher cumulative doses and a longer duration of treatment can increase the probability of ovarian damage.
Fertility Preservation Options
When you are considering fertility preservation options, it is important that you discuss the most appropriate pathway for you with your fertility specialist.
| Method | Who is it for? | Overview |
|---|---|---|
| Embryo Cryopreservation | Patients with a partner or those using a donor | Eggs are fertilised in a lab, and the resulting embryos are frozen |
| Egg Freezing | Single patients or those who do not wish to use donor sperm | Mature eggs are harvested and frozen for future use |
| Ovarian Tissue Freezing | Patients who cannot delay cancer treatment | A small piece of ovarian tissue is removed and frozen |
| Ovarian Suppression | Patients awaiting chemotherapy | Medications to rest the ovaries during treatment |
Pregnancy After Cancer
It is common for a woman to be concerned about what pregnancy could look like after breast cancer treatment and whether cancer could return after conception. So far, there is no evidence that pregnancy after breast cancer increases the risk of recurrence.
Women may have other concerns, including:
Is it safe to breastfeed after treatment?
It is generally considered safe to breastfeed your child from the unaffected breast. However, women who underwent breast-conserving surgery may have reduced milk supply in the targeted breast.
How long should women wait before trying to conceive?
It is usually recommended that a woman wait for at least 6-24 months after active treatment.
Does prior cancer affect the health of the baby?
Children born to breast cancer survivors are generally not at increased risk of birth defects or adverse health outcomes.
Conclusion
A breast cancer diagnosis can be life-altering, but it is not necessarily the end of a woman’s dream of biological motherhood. The field of oncology has made incredible strides in oncofertility, allowing women the best options to preserve their reproductive future both before and after treatment. The best thing you can do for your fertility is to consult an oncologist and a fertility specialist before and after chemotherapy, radiation, and other treatment methods.
Patients should be aware of the warning signs that call for immediate medical intervention. Early detection is beneficial in expanding treatment options and, ultimately, preserving fertility.
Frequently Asked Questions
Is there enough time to freeze eggs before starting chemotherapy?
Yes. Fertility specialists can begin the egg-freezing process at any point in your menstrual cycle. This process usually takes around 10-14 days, meaning that it does not cause any significant or dangerous delay in cancer treatment.
Can I get pregnant naturally after chemotherapy for breast cancer?
Many women are able to recover ovarian function after chemotherapy, especially those under the age of 35. That said, the likelihood also depends on other factors, such as the type of chemotherapy used, the dose, and the duration of treatment.
Can I breastfeed my child after successful breast cancer treatment?
Yes, breastfeeding is generally considered safe after successful treatment, particularly from the unaffected breast. However, surgery or radiation may create latching issues or reduce the milk supply.
Are there any herbal remedies that help maintain fertility?
There is no scientific research on the effectiveness of using herbal supplements or natural remedies to preserve ovarian function before or during the process of chemotherapy. It is necessary to consult your oncologist because some supplements can impact the treatment.
Can pregnancy lead to the recurrence of cancer?
No, this statement is a popular myth among women who have survived breast cancer. Nowadays, scientific data proves that pregnancy does not raise the chances of cancer relapse, even for ER+ breast cancers.
