Pregnancy after breast cancer

Dr Wendel C. Guthrie, CONTRIBUTOR

Because of early detection and improved treatment, the mortality rate from breast cancer has improved significantly over the past 25 years in most countries.

Many women surviving breast cancer are still in their reproductive years, and the question of pregnancy after treatment will arise. In addition, women are putting off child-bearing for later in order to pursue careers.

Although many reports confirm that breast cancer diagnosed during pregnancy tends to have a poorer outcome, there are reassuring reports that pregnancy after treatment is possible without risk of recurrence.

Pregnancy is not recommended during treatment with chemotherapy or radiotherapy.

After treatment is complete, many women will experience ovarian failure as a result of the chemotherapy, and will not produce ova (eggs), as evidenced by the absence of menstruation and menopause symptoms, such as hot flashes and vaginal dryness.

In some cases, the ovarian failure will be permanent, while others will be temporary and return to normal periods and ovulation. Some women may not require chemotherapy and not experience ovarian failure.

preserving embryos

For younger women, ova can be removed and fertilised prior to chemotherapy and the embryos frozen until needed. If there is no appropriate sperm donor, the ova may be harvested, however, at this time, the results of preserved ovum are not as good as preserved embryo.

The decision to become pregnant will depend on many factors, such as the age of the woman, the extent of the disease when diagnosed, the response to treatment, whether or not the tumour was oestrogen receptor sensitive, and her general state of health.

Most caregivers will use non-hormone contraceptive (such as intrauterine device) or barrier methods while the decision to become pregnant is contemplated.

In conclusion, women treated for breast cancer can have successful, subsequent pregnancies.

Dr Wendel Guthrie is agynaecologist and volunteer/board member at the Jamaica Cancer Society. wengut@cwjamaica.com

Although many reports confirm that breast cancer diagnosed during pregnancy tends to have a poorer outcome, there are reassuring reports that pregnancy after treatment is possible without risk of recurrence.

Cancer-fighting foods

Researchers at the Harvard School of Public Health in the United States recently linked vegetable consumption to a lower risk of oestrogen receptor-negative (ER-negative) breast cancer, an aggressive type that isn't fuelled by hormones and affects about 15 to 20 per cent of women with breast cancer, particularly younger women.

Meanwhile, another study revealed that women with higher blood levels of carotenoids - micronutrients found in fruits and vegetables - also had a lower risk of ER-negative cancer.

Moreover, berries have been shown in recent studies to reduce the number of ER-positive tumours - the type of breast cancer that affects 70 per cent of sufferers, noted Harini Aiyer, PhD, a research scientist at the Medical College of Wisconsin in Milwaukee. She recommends eating a cup of berries each day.