Making the decision to have a baby after breast cancer

Hi, apologies for creating yet another post on having babies after breast cancer, but having read and contributed to some I still don’t feel I have got the wisdom I actually need from all you lovely ladies out there.
I am 3 years 3 months post diagnosis, 2 lumps left breast, small (6mm and 1.8 mm), 3 nodes with micro mets, grade 2 ER+ PR+. Her -, chemo, masectomy, on tamoxifen. Had a 19 month little girl when diagnosed and was trying for second baby at diagnosis.
Completly removed the thought of being able to have another baby from my mind for the last 3 years. Have been post menopausal from chemo and also had zoladex. The beginning of the year my periods returned and Onc confirmed I am now pre menopausal. Did some research into pregnancy after breast cancer and it seems and consultant confirmed that there is no research to suggest that having a baby would make the cancer come back, which surprised me. I have always wondered if having my daughter triggered my breast cancer as consultant said lumps had been around for a minimum of a year max of two years. High levels of hormones in pregnancy, hormone positive cancer surely this is common sense, or maybe not!
The dilemma I have is do I have another baby? I always wanted two children and have struggled a lot that this would not be possible. But equally I fear that having a baby would trigger secondaries or another primary in my other breast and then I would not be around for not just one but two children. But, if the research is to be the case, then having another baby should not make any difference to my prognosis, so why am I denying myself something that would make my little family very happy.
I have spoken to my consultant and he says it is not the pregnancy that is the issue, it is whether considering the risk of my cancer returning based on my diagnosis. He showed me all these prognosis tools and now I am more confused than ever. He suggests I stay on tamoxifen for the full 5 years but he said if I were closer to 40 he would say come off it sooner to try for a baby. I’m 33. The research is confusing about how long to stay on tamoxifen and he also said that if I were at 5 years and did not want a baby then he would keep me on tamoxifen for a further 2 years.
Sorry for long post, but I would really like to hear from women who have been in my position or similar position and how they made their decision to either have a baby or not. Any advice or views also very welcome.
Boo
x

Bumping up for you.

Have replied to your PM.

x

Hi Boo

This is the royal college of obs and gyn guideline produced last year…
http://www.rcog.org.uk/files/rcog-corp/GTG12PregBreastCancer.pdf

They cannot say for sure if your cancer would return or progress but i would say from what you have said things def sound in your favour… Grade 2, under 2cm, her2 neg, hormone pos, micromets in nodes! And had Mastectomy, chemo, tamox and zoladex… So you have done all the treatment to minimise the risk of recurrence, spread or new cancer…

Pregnancy itself wouldnt cause cancer but having a pregnancy doesnt mean it wouldnt have come back anyway… Eg somebody may get a recurrence when they are 40 whether they have a pregnancy or not after a primary bc… Just like you would prob still have gotten bc whether you had your daughter. But the research does show that BC recurrence isnt increased following pregnancy… But its a very personal decision that only really you can make… One of my friends is expecting her first baby 3 years after being diagnosed and about 2 years after treatment finished… She is in her 20s.

Good luck xx

Thank you Lulu34, I have seen this guidance but believeing it is another thing! Like you say it is really my call, what I am interested in is those who had this same decision to make and whether they decided to have another baby or have a baby and how they reached that decision. Also interested in hearing how long the hormone positive ladies stayed on tamoxifen before coming off it to have a baby.
Any views welcome and received with thanks.
xx

Hiya Boo,

I’m in a similar position to you. Dx march 2010, though at 36 I was a bit older than you! 17 mm slightly ER + tumour, invasive ductal cancer, clear margins after lumpectomy, no evidence of spread to lymph nodes or vascular invasion, her -ve and grade 3. My periods faltered and stopped during chemo, but I’ve had two heavy periods this year. I am frustrated that I don’t know what’s happening with my own body. My oncologist didn’t think they’d come back when they hadn’t after 18 months, but then they did reappear, but they aren’t regular. He thinks I am perimenopausal and they will reduce and end. I think my body is kicking back in, I can feel my cycle and have done throughout their absence, and I think my tamoxifen is subduing them, but Inc says no evidence of this.

When I was dx, we were trying for a third baby. We fortunately had nt fell pregnant and I didn’t have eggs preserved as I wanted to crack in with treatment and felt I owed it to my existing children to do everything possible to be here for them rather than put myself at risk for my own purposes.

However, I went through so much heartache after dx about my baby plans being smashed to pieces. I felt, and still feel, that there is a member of my family missing and that that baby and person is out there, waiting to be born. These are the feelings in my stomach and my heart, but my brain is telling me different things. How can I put myself even remotely at risk, shouldn’t I be protecting myself and my boys and putting my own heartbreak to one side? It’s a constant discussion that flits through my head frequently.

At my last oncology check up my husband asked for us to be referred to the fertility experts ( as he was sick of me going n about it I think!) and the forms have just come through for me to complete. I’m mulling over them now, I don’t know what to do. I wouldn’t go down the IVF route and put me and my family through that, I am sure of it, but I want to know how feasible a pregnancy would be without this and whether coming off tamoxifen might regularised my periods. I think I want them to test my hormone levels and give me an idea of what is going on in my body. I feel in limbo land.

And if I can go ahead with a pregnancy, should I? I feel cheated that I am now 38 and there will be a bigger gap between any future child and my other two boys. I know the literature and recent research says it doesn’t increase your risk of recurrence, but my oncologist said that the research isn’t a proper randomised trial as you cannot possibly do that with pregnancy and breast cancer and that a lot of the evidence is anecdotal. Apparently the numbers of post breast cancer pregnancies worldwide is comparably small so it’s hard to base advice on.

Sorry I have not been more helpful, I just wanted to let you know you are not alone. I feel somewhat removed from those first horror after dx feelings now but have to weigh them up to know exactly what I am dealing with. I just don’t know the answer. I think the safe thing is to stay as I am, I am incredibly lucky to have found and been treated for my cancer early and to already have two little boys and a proper family. How can I risk feeding any lingering cancer cells which may be in my body (touch wood they don’t exist in any event now!) with pregnancy oestrogen and not being here for my boys and a new baby, and leaving my husband with three little ones to look after? How on earth do I make that decision? Meanwhile my heart feels like it could break when I see families with three or more children and I find myself scowling at them and feeling jealous. Not pleasant!!!

Good luck with your decision
Xxx

Hi Tors
Thank you for taking the time to respond. It is nice to know that others are in a similar situation with the same dilemmas. It is interesting what your Onc says. My consultant, the one who did the surgery seem pretty happy for me to try and have a baby, but feels a lot more comfortable it I stay on the tamoxifen for the full 5 years. I have not spoken to my Onc yet about this, but from experience of other things he often differs in advice from the surgeon, so I will see what he says. I really don’t know what I will do, in some ways I have time and perhaps I need to try not to obsess over making a decision now. Not easy though!
In some ways I think it would be easier if the advice was that pregnancy increased risk and not to go ahead with pregnancy, then I think my mind would be made up and I would accept my very dear little girl and not keep thinking about whether I could have another. For so many years since diagnosis I have felt my pregnancy caused my BC, but I have wondering whether it may not have been that. I have been reading about the contraceptive pill and BC and I was on the pill from 15-16 years old until 27 years old, maybe it was this that caused it, maybe coming off it triggered a change in hormones or whatever and the cancer may have started after I came off the pill and not necessarily as a result of the pregnancy. They do say that women who have babies are less likely to get BC, they also say that women who use the pill before having a baby are at a higher risk of developing BC, as well as those who a family history of BC, my Dad’s Mum was diagnosised age 42 with BC, died age 55. I have been Braca tested and it is negative.
I am seeing a clinical psychologist who specialises in helping people live a fullfilling life after a diagnosis of cancer and have started to talk this very issue through with him. He is the one who has suggested I decide I am not going to make a decision now. I hope this helps and helps me come to a state of peace in all this.
Boo
xx

Hi Boo

I am 30 years old and was diagnosed with bc at beginning of this year. I have had a mastectomy and immediate reconstruction, currently undergoing chemo and will then have rads followed by tamoxifen and zoladex. My tumour was 5.5cm, grade 3, ER+ with 1 node involved. I don’t have any children but before diagnosis I had fallen pregnant and unfortunately lost the baby at 20 weeks. At the point of diagnosis I found out I was pregnant again and had to make the worst decision of my life, to terminate the pregnancy. I didn’t have a choice regarding freezing any eggs before chemo, was told it was too risky because of all the hormones, so I am left in limbo not knowing if I will even be able to have a baby in the future.

My onc knows my history and how important having a baby is to both me and my OH and he has already told me that he will allow me to break from the tamoxifen after 3 years to try for our baby. He says there is no link between having a baby and bc/reoccurance and has even offered to put me in touch with other women of my age that have gone on to have children after bc.

I think for me, having a baby is that important that I will put the trust in my onc and try after that 3 years. I may get in touch with some of the other women as well if I have any questions.

Good luck with your decision and I hope you get the answer you are looking for.

Nat xxx

Hi Nat
Sorry to hear your story, it never ceases to amaze me (not in a nice way) how many young women there are that keep going through this. It is bad enough having BC but for it to come at a time in your life when you have other equally trumatic things to deal with, like a loss of a baby, it is just totally cruel! I wish you all the very best with the rest of your treatment, I had chemo, no rads but took Zoladex and are still taking tamoxifen. Had masectomy and immediate reconstruction too. I feel in a relatively strong place 3 years on, OK apart from this dilemma to try to have another baby or not!, if I can help in any way, answer any questions always message me.
Thoughts and wishes
Boo
x

Hi Boo, Just a little message to let you know I also am in a similar predicament. I am also 32 and due to my partners fertility issues we was two weeks away from starting IVF treatment which had taken us 3 years to get to that point when I was diagnosed with Hormone + Her2 - cancer two 4mm tumours 11 of 17 lymph nodes with micro invasion in 1. i have been strongly advised to stay on tamoxifen for 5 years which i have now accepted. As we was so close to having IVF they allowed me to go ahead and have my eggs frozen before my operation, its all a bit of a blur now as it happened so fast but we have 8 frozen embryos which is great but obviously it plays on my mind that maybe injecting hormones into me might have stirred something up again. But my main concern now is will a pregnancy trigger bc again, like you it makes sense if they said a increase in hormones due to pregnancy would cause a reacurrence but instead my oncologist has claimed it shouldnt provide me with any risks. Because of my paranoia myself and my partner have even discussed going down the surrogacy road so not to risk it but this would be costly and so hard and im sick of fighting for a baby. Like you aswell I was on the contraceptive pill for over 10 years and think could this have been a trigger as came off it 3 years before diagnosis. It just doesnt end at the treatment does it, this cruel illness affects our whole life. I wish we knew the answers so we could plan our future, all i want is a baby and obviously a long life. I hope we all get what we so very much deserve
Hobo x

Hi Hobo,
Thanks for sharing your situation too. I think from what I have read from others experiences that Onc do rather seem to say stay on tamoxifen for 5 years when there is lymph node involvement. I think if there is no lymph node involvement, they feel more relaxed in saying less years. I think for my own piece of mind I will leave it the 5 years but it is so tricky as having a baby is what I really want to me doing with my life now not in 3 years time! I hate feeling like it is a waiting game because life is far too short for that. I did in the beginning spend a lot of time on nice holidays but sadly the money is fast running out so I can’t even convince myself that I am doing all these luxury holidays I couldn’t do with a baby. It is so tricky, and like you say all we want is what all our friends seem to have but don’t realise how lucky they are. What’s micro invasion? I had micro mets in 3 out of 11 of mine, your lumps were sooooo small, not come across many women with two lumps like us most seem to have one.
Boo
x

Boo, you’ve hit the nail on the head. For me, life is a total waiting game - waiting to see if the cancer spreads, waiting to finish the next 4.25 years of Tamoxifen, and waiting and praying and hoping for the chance to think about trying for a family again. Hate the waiting game. Too many unknowns and hate tgat part of me just wants to fastforward time as our experience shows how we should be making the most of life and living each day to the fullest. But nothing seems as important as my desire and need to have a family…

Hi All (if you read this!)
Just an update from me following my latest appointment with my Onc. He did agree with my surgeon in that there is no latest research to suggest that pregnancy causes further breast cancer or effects your prognosis. He says definitely stay on tamoxifen for the full 5 years, maybe even more (subject to what future research shows up). He said he would support me having a baby after that but would want me to have a full body scan to make sure there is no signs of mets anywhere. I expressed my concerns about the timings of my breast cancer to pregnancy with my daughter and he couldn’t really say another about that. I said I was concerned that in my case the pregnancy may have caused/ triggered the breast cancer and if this was the case then in my individual case it would not be wise to repeat this. Again he couldn’t really say anything to this. He suggested I wait another 2 years to the full 5 years, have the scans done and then have the conversation again then. He did say that in my situation where I have one child I may want to not risk having another baby. He said it is very different for women who have not had a baby. I do agree with him in some ways but on the flip side of this, if pregnancy is safe for a women who has had breast cancer and has not had a child surely it is safe for a women who has had a child (or more) and wants another. It’s a pregnancy after all. He also said that the pregnancy makes it very difficult to monitor someone, because you can’t have scans, the blood tests are all over the place and can mimic raised tumour markers etc. My husband certainly came away with the opinion that the Onc thought it was best not to have another baby. Easy for him to say!
Where does this leave me now and how do I feel?
Very unsettled again! One part of me feels that if the surgery and chemo were successful and removed all cancer then I should be cancer free. If they didn’t and the tamoxifen is keeping it at bay then it will come back whether I stay on tamoxifen for 3, 5 or 10 years, have a baby or not. Some days I feel fine about getting on with life and enjoying the little girl I have but other days I just want to be like all my other friends and have the second baby I always wanted. I feel well, positive about my prognosis and to this end, why should I not try to have another baby. Afterall I don’t know if I will be able to. I am having irregular periods but I have no idea what the chemo may have done to my egg quality. That all said I would not want to go against the professionals recommendations and to this end I will have to wait, but I do feel like I’m waiting to find out whether I have secondary cancer by year 5, or whether I’m clear and get to have another baby. That will be what will happen in 2 years time, the scans will either show cancer somewhere or will show it to be clear, and living with that thought is not pleasant. And all this because my body and heart is telling me I want another baby.
It is so pants, and I know several of you on here are in the same situation as me which is a little reassuring.
Anyway that me…
Boo
x

Hiya Boo, thanks for posting your update. These just no right answer is there? Have you seen that I’ve set up a Facebook support network for younger women who have had a breast cancer diagnosis? There are nearly 60 of us now, all in the last week since I set it up. We are chatting about lots of young woman related bc things, fertility, pregnancy, breastfeeding, periods etc are all topics of conversation. Please think about popping along to join us, we’d love to have you. The page is called Younger breast cancer network (uk). It was originally for Manchester ladies, local to me, but soon became clear there was a need for it. For women from all over. Once I accept you into the private group you can chat without anybody outide of the group being able to see it.

Anyone else reading who is a younger woman at any stage post dx is welcome to join too.xxx

I’ve bumped the thread up about the Facebook page for you boo xxx

Thanks Tors I will find it and join. Boo x

Fab xxx

Have posted this elsewhere but I think it could be quite encouraging for you so am posting here.
My sister had breast cancer aged 32. Grade 3 and in several nodes. She had lumpectomy, all nodes removed, chemo and radiotherapy. She wanted more children so did not opt for the strongest chemo. She chose to take tamoxifen for 2 years only. 4 years after diagnosis she had another baby girl. That was 10 years ago. She has had dcis in the other breast-widespread so had to have mastectomy but absolutely no invasive cancer. I might add she has lived life to the full and not stuck to a healthy diet in any way and enjoyed many many glasses of wine, parties, late nights and only the odd bout of exercise. I’m not suggesting this as the best lifestyle choice but seems to be working for her at the moment.
There is definitely life (lives) after cancer!

Hi there
I was diagnosed with breast cancer in April 2009 at the age of 37 having just completed one round of IVF (unsuccessful with no embryos frozen). The cancer was large (6cm) and aggressive (ER/PR + and HER2+) so unfortunately we couldn’t have a further round of IVF to preserve eggs/ embryos. In 2011 we had three more rounds of IVF . I had an AMH level which tested at below 1.14. Each time I had about 6 eggs. In the third and final round of IVF, we conceived. We now have a gorgeous four month old son who I gave birth to at the age of 40. Having to make the decision to come off tamoxifen and increase my risk of cancer recurrance to try for a baby was the hardest decision I’ve ever made. I’m now back on tamoxifen and will be for a further three or so years (I was on it for 1.5 years before stopping to try for a baby). I do worry about reccurance, but am so, so happy that we took the risk.
Lisax

i was diagnosed with invasive bc beginning of oct, 22mm in size, lymph nodes clear
had successful lumpectomy and clear margins, now got to have 15 sessions + a further 8 sessions of radiotherapy, have been advised to take tamoxifen for 5 years but the oncologist would be prepared to let me take it for 2 years
i am 43 years old and would like to try for a child (i don’t have any), i am debating whether to start taking tamoxifen but am finding it difficult to get any help or find any info as to what the stats are for bc returning if i don’t take the tamoxifen

Hello all,

I’m reading this thread years after it was posted. I am facing the same question.  Logically, I don’t understand how pregnancy could not trigger an ER+, PR+ breast cancer type, although there is still no research that proves it. But then if you’ve had all breast tissue removed, how could it return?  

Could anyone share with me if they made a decision and if you chose to have a baby, if you’re still cancer-free?

Thanks,

ali555