Women who have survived breast cancer have a significantly harder time conceiving than women who have not, according to the results of a recent study presented at the virtual 2020 San Antonio Breast Cancer Symposium (SABCS). Survivors should take heart, however, because odds are their babies will be healthy.
Cancer treatments such as radiation and chemotherapy are known to impair female fertility by damaging reproductive organs and depleting egg stores, reducing the likelihood of pregnancy post-recovery. It’s one of the many ironies of the disease: In saving yourself from death, you risk ending your bloodline.
“Today, returning to a normal life after cancer diagnosis and treatment should be considered as a crucial ambition in cancer care. In patients diagnosed during their reproductive years, this includes the possibility to complete their family planning,” corresponding author Matteo Lambertini, MD, PhD, of the University of Genova in Italy, said in an SABCS press release.
Conducted by researchers in Europe and the Americas, the study involved a systematic literature review of data on 114,573 women who had survived breast cancer. The researchers found that survivors were 60% less likely to conceive than women in the general population. However, Lambertini clarified that this figure did not distinguish between survivors who wanted children and survivors who did not want children, meaning that it is likely somewhat inflated.
The analysis also showed that survivors, particularly those who had undergone chemotherapy, were 45% more likely to go into labor early and 14% more likely to give birth via Caesarean section. Their babies, meanwhile, were 50% more likely to have a low birth weight and 16% more likely to be small for their gestational age.
However, Lambertini and colleagues did not find that survivors were any more likely to experience complications during pregnancy or delivery or that their babies were any more likely to have birth defects.
Becoming pregnant may even confer women survival benefits. Pregnancy was associated with better patient outcomes regardless of BRCA status, chemotherapy exposure and pregnancy interval—defined as time between breast cancer diagnosis and pregnancy—among other factors. Survivors who conceived were around 44% less likely to die and 27% less likely to experience a cancer recurrence than survivors who did not.
Lead author Eva Blondeaux, MD, of IRCCS Policlinico San Martino Hospital in Genova, said the results of the study indicate that while women with a history of breast cancer should receive additional care during pregnancy, they are perfectly capable of conceiving and delivering naturally.
“These findings are of paramount importance to raise awareness of the need for a deeper consideration of patients’ pregnancy desire as a crucial component of their survivorship care plan. This starts with offering oncofertility counseling to all newly diagnosed young breast cancer patients,” Lambertini said.
To read more about how fertility is affected by cancer treatment, click here and here. To read about options such as egg freezing and ovarian cryopreservation, click here.
To read about a population that is particularly at risk for breast cancer, click here.