Older Moms and Breast Cancer Risk
Elizabeth Edwards’ Breast Cancer Raises Issues About Older Motherhood, Fertility Drugs
"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.
Fertility and Breast Cancer: What Women Should Know
Some of the evidence that hints at links between late-stage motherhood, fertility drugs, and breast cancer can be found in the results of the massive Women's Health Initiative Study published by The Journal of The American Medical Association in 2002, with an update in 2004. It was here that research on some 16,000 women revealed that the use of combination menopausal hormones (estrogen and progestins) significantly increased the risk of breast cancer, particularly when used by older women.
Smith points out that not only do some fertility drugs increase estrogen levels, but she also believes that flooding the body with significantly high levels of this and other reproductive hormones, at an age when your natural risk of breast cancer is on the rise, raises a red flag we should not ignore.
"It's not that great a leap of faith to tie what we learned about hormones and breast cancer from the WHI to what we might learn in the future about fertility drugs and breast cancer," says Smith.