How Breast Cancer Affects Fertility
What there is to know about having a baby when you have breast cancer.
Conception Concerns: Relapse, Harm to Offspring
For survivors who remain fertile, questions about conception remain. Relapse is one of them.
"A common clinical recommendation is that a survivor wait two years before attempting to become pregnant, since most serious relapses will occur within the first two years after treatment," Barbierri tells WebMD. "If you wait two years, there's no strong evidence that pregnancy will influence the course of disease."
Survivors also worry that their offspring will be at risk for cancer. According to experts, that risk is small. "Only 5% of breast cancers are truly inherited via a specific genetic mutation," Domcheck tells WebMD. "If you have an inherited genetic mutation, you have a 50-50 chance of passing it on to your children." To date, researchers have identified a few genetic mutations that contribute to breast cancer; these include BCRA-1 and BCRA-2.
What is the prognosis for offspring who do inherit one of these genetic mutations? "There does not appear to be an increased risk of childhood cancers. However, these children are at a slightly higher risk for developing ovarian and breast cancers," Domcheck says.
But genetics are only part of the picture.
"It's likely that an interplay between a collection of genes, when added to certain environmental factors, results in breast cancer," Domcheck says. Known environmental risk factors include moderate or heavy drinking (for women, two or more drinks per day), having children later in life, and obesity.
Survivors also question the impact of cancer treatment on future offspring. The news on this front is very encouraging. "There does not seem to be any increased risk of birth defects if the woman who's gone through breast cancer treatment gets pregnant. Even if the woman gets chemotherapy during pregnancy, fetuses do surprisingly well," Domcheck tells WebMD.
Addressing Fertility With Your Doctor
Absorbing news of a breast cancer diagnosis as well as focusing on how it might affect future fertility can be overwhelming. But because oncologists are trained to provide the best cancer treatment available -- not necessarily in light of fertility options -- patients interested in seeking information on fertility need to be proactive.