Older Moms and Breast Cancer Risk
Elizabeth Edwards’ Breast Cancer Raises Issues About Older Motherhood, Fertility Drugs
"These are the kinds of numbers that give rise for concern," says Smith.
Another concern: The method that was used to help John and Elizabeth Edwards conceive their last two children. Elizabeth Edwards' advanced age prompted brief media speculation about the use of donor eggs. Since it's a subject she has not discussed in public, it's not known if that path was taken.
However, what she has reportedly acknowledged is the use of fertility medications -- hormone-based drugs that stimulate ovarian egg production. The medications are also used to encourage maturation of the uterine lining necessary to sustain a pregnancy. And this, say experts, places yet another huge question mark in her breast cancer risk profile.
"We don't know one way or the other if there is an increased risk of breast cancer associated with taking fertility drugs because thus far, the data has been conflicting. But it's certainly a question that needs to be addressed further, and certainly needs to be answered," says Margareta Pisarska, MD, co-director of the Fertility Program at the Cedars Sinai Medical Center in Los Angeles and editor-in-chief of the American Society for Reproductive Medicine News.
The National Institutes of Health reports that the breast cancer risk for all women at age 40 is 1 in 235. By the time a woman reaches age 50, that risk jumps to 1 in 54, and by age 60 it's 1 in 23. The lifetime risk of getting breast cancer is 1 in 9.
There are thought to be some 6 million couples grappling with infertility in the U.S. alone, with those seeking treatment steadily on the rise since 1978. According to the CDC, in 2001 there were 69,515 in vitro fertilization cycles using fertility drugs and a woman's own eggs and 12,000 more using donor eggs.
Thus, Smith says that if there is a link between fertility treatments and breast cancer, a lot of women stand to be affected. Edwards' age of 55 places her at increased risk, says Smith, even without her fertility issues at stake.
Another point to consider: Some studies suggest that body mass index and weight gain may be related to the risk of breast cancer. In this respect, Edwards' weight may have worked against her health as well.
"When you combine the weight issue with the advanced age of first-time pregnancy, and her age at her last pregnancy, and the use of fertility drugs, a serious risk profile begins to emerge," says Smith.