When you're diagnosed with breast cancer, you have so many decisions to make, and so many emotions to deal with: fear, anger, despair. It can be overwhelming. Then, if you want to get pregnant and have children in the future, the medical decisions become even more complex.
It's not easy to study pregnancy in women with breast cancer, or women who have been treated for breast cancer. It's difficult to find women with the same cancer status and fertility outcomes, who can be compared in randomized clinical trials. The studies done so far have mostly looked at small groups of women. As a general recommendation, many doctors advise premenopausal woman with early breast cancer to wait about two years after diagnosis and treatment to get pregnant. This recommendation was made because early breast cancer that is going to come back usually does so in the first two years after diagnosis and treatment. Premenopausal women diagnosed with advanced breast cancer usually have treatment that lasts longer than two years after diagnosis. Because treatment may be ongoing, decisions about pregnancy are more complex for women with advanced breast cancer.
A study found that women with early breast cancer may not need to wait two years before getting pregnant. Waiting six months appeared to cause no significant increase in cancer or pregnancy risks. This study also confirms that women diagnosed with advanced breast cancer face more complex decisions about pregnancy timing. Pregnancy timing is also more complex for women who need ongoing treatment.
Perhaps the most important message is that nothing is written in stone. If you want to get pregnant and your diagnosis and treatment are favorable, waiting more than six months may not be necessary. Work with your doctor to identify and understand the specifics of your own "big picture." Then, think about your personal wishes and concerns together with the best interests of the child you're hoping for. If you're in a relationship, then your partner's concerns will also weigh into the decisions you make. Together you can work out your priorities and develop a plan.
If you are being treated for breast cancer or have a personal history of breast cancer and are considering having a baby now or in the future, here are some questions to explore with your doctor:
- Do I feel well enough and strong enough to go through pregnancy and birth?
- How long after treatment should I wait before trying to get pregnant?
- Considering my age and the treatment I received, how likely am I to get pregnant?
- Are there any treatments I'll have to stop if I want to get pregnant?
- Are there any risks if I stop treatment to get pregnant?
- Will I be able to continue treatment after I have a baby?
- If I can't get pregnant, what kind of infertility treatments can I safely take?
- Can I bank my eggs before chemotherapy in case I can't produce eggs after treatment?