Having recently found out I am pregnant approx 18 months after my treatment finished (lumpectomy, 6xTAC, 15xrads) I was referred to the consultant obstetrician at my local hospital. He referred me to this publication from the Royal College of Obstetricians and Gynaecologists which provides evidenced-based advice on breast cancer and pregnancy, either in relation to fertility preservation, impact of chemo or on getting pregnant thereafter.
In short it answers all the questions I tried to find out about when I was diagnosed - see the older thread on Fertility & Chemo for the full story. I would have hugely benefitted from this publication and its matter-of-fact presentation of the medical evidence at the time, so i thought I’d share it with you all, in hopes it helps some of you avoid the confusion and trauma I experienced when diagnosed. You can find it here - rcog.org.uk/files/rcog-corp/GTG12PregBreastCancer.pdf
To flag a couple of things - firstly, quite contrary to everything I was told/read at the time, it suggests that even oestrogen +ve women do not not need to necessarily avoid pregnancy, I quote:
"Women can be reassured that long-term survival after breast cancer is not adversely affected by pregnancy.
Since many breast cancers are estrogen receptor positive and endocrine responsive, women used to be advised against pregnancy because of concerns that it would worsen prognosis. However, the evidence from the published studies is reassuring, showing either no impact on survival or improved survival. (!!! - my exclamation marks). Despite the limitations of the studies, which are mainly retrospective case–control series with limited numbers,they at least demonstrate that outcome after treatment for breast cancer is not adversely affected by pregnancy."p.6
And secondly, regarding the use of GnRH analogues (like Zoladex) to protect against infertility during chemo, although it acknowledges there is insufficient data at present to draw firm conclusions, it also says, again quoting “A recently reported randomised controlled trial in premenopausal women with breast cancer found that co-treatment with GnRH analogues during chemotherapy lessened the risk of ovarian damage (35/39 resumed menses versus 13/39, P < 0.001).” Page 9. This is pretty impressive results, even if it is only an early study. I certainly warrant my returned fertility to being given Zoladex injections throughout chemo (though I also now learn from this publication that perhaps my chance of losing my fertility was always only about 5% given I was only just 30 when diagnosed, and given that I was given a Taxotere chemo regime which also seems to be better for fertility preservation!
All of which would have been very useful to know at the time! Happy reading folks.
Congratulations! I hope your pregnancy goes brilliantly.
Interesting article. Thank you.
Upsetting that only 10% of young BC ladies go on to have babies. I hate that we have to hope to be in the majority for these stats and in the minority for those stats etc…
Bump because this information booklet is fantastic. Thank you for posting it because at the very least it puts in a younger ladies mind the types of questions and issues they should be considering regarding fertility and pregnancy post primary bc diagnosis. Thanks for posting this, I have found it really really helpful.
Hi
I have to confess I rarely come on here- was too poorly whilst on treatment to open my laptop, then after I was too shattered and 18 months on, well I don’t know why but a friend forwarded the link to this post and article and its been so interesting and useful to read, why couldn’t my onocologist just have given it to me, wouldv’e prevented alot of worrying, heartache and appointments spent interrogating drs!! So big thank you for posting it!
Congratulations on your pregnancy, such lovely news. May I ask do you feel you are being given lots extra support like it says in the article?
I recently had an appointment with reproductive meds drs and had the ovarian reserve blood test (get results in January). Not sure if they’re ok and oncologist says we can go ahead and try to get pregnant when I’m two years post diagnosis (April) how I will feel-maybe time will help?
Well done you AND beating the odds at being one of only 10% that get pregnant after BC, thats amazing!
x
Hi,
Did your periods stop whilst having chemo? I had a masectomy and then went for egg harvesting as a precaution. I had 3 fec and 3 tax. I am starting radiation soon and then have to make a hard decision as to weather to take Tamoxifen for 2 or 5 years. I want to start a family before I am too old (will be 37 when I come off tamoxifen after 5 years) I was diagnosed just after my honeymoon at 31.
I’m 2 years older than you and starting radiotherapy in a few weeks and am starting Tamoxifen next week. My husband and I had just started trying for children when I was diagnosed. Strongly ER+ and large tumour so egg harvesting was a no go. I’ve spoken to my onc and surgeon about it and they said the benefit of Tamoxifen is exponential - so a much bigger benefit at the beginning - and have suggested that I wait for 2-3 years and if I have no recurrence or evidence of spread by then that will be very promising and they will take me through all of the risks of coming off Tamoxifen early having got through the riskiest time.
It’s horrible though, isn’t it. I was so happy and had everything planned out…and now nothing is certain.
Hi all,
Sorry I haven’t been back sooner.
Thanks for your congratulations and glad people have found this publication useful.
I agree - why didn’t my oncologist know about it! I shall be presenting her with a copy at my next check up in a couple of weeks and suggesting she pass it on to any younger women who come through her doors! In answer to your questions, better late than never…
I am not getting amuck extra support no, but I don’t really feel I need it at the moment. I was referred to an obstetrician at the start of my pregnancy but he didn’t have much to say, other than referring me to the very good publication! My midwife has been good and has said I can see her more often if I like (she delivered my daughter Mabel so knows the story well) but unless something goes wrong I don’t really need to. I guess the thing is that the complications are not really about pregnancy but rather about cancer so if anyone were to give me extra support it ought to be the oncology team. They have decidedly not done so - in fact, I haven’t heard a peep from them, which I have to say surprises me. We shall see what they say as I have a check up in two weeks by which time I’ll be seven months. To be fair, however, my cancer was triple negative so there are not the oestrogen worries that others have. Though that said I did obviously develop the tumour whilst pregnant so whether it is really a coincidence remains to be seen. From my point of view I could have done with extra support early on to cope with excessive paranoia - the trouble being that all the symptoms they say you should worry might mean a reoccurrence, are much the same as the symptoms of pregnancy - tiredness, aches and pains, back ache, shortness of breath etc. Still, I am mainly calm now (despite impending two year deadline!).
To answer about my periods - yes they did stop during chemo - and started again about six months later, whereupon I got pregnancy almost immediately and then lost at about 10 weeks. At that point incidentally the BC nurses were very hands on and gave me lots of extra support - they met me at 8am on the morning of my D&C operation to hold my hand and mop up tears.
Anyway, this time all is fine, bar being exhausted and a bit paranoid. Fingers crossed it stays that way.
Love to you all, Jess
Many congratulations on your pregnancy - this will give so much hope to other ladies too.
Thanks from me also for highlighting this publication - haven’t read it all yet, just skimmed it for now but I wish I had been given a copy of this when I was dx whilst pregnant in 2006 - not sure if a copy was available then. My onc told me not to get pregnant again which left me devastated - yet another choice that cancer stole from me.
I am going to try and move this link from you into the ‘Pregnant with Breast Cancer Category’ which also covers fertility. If I can’t do it I wonder whether the Mods could do a better job than me?
Good luck with the rest of your pregnancy and keep us posted.
Thanks for the article. Just been diagnosed last feb 5 and had left mastectomy and lymph node bx on the 20th. I’m 41, just started planning a family then I was diagnosed. I guess there’s a little hope for me to be a mommy now. I’ve been told that my fertility treatment will need to be self funded as I am on my 40’s and this has given me lesser hope as we are not prepared yet for this financially.