Older Moms and Breast Cancer Risk
Elizabeth Edwards’ Breast Cancer Raises Issues About Older Motherhood, Fertility Drugs
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.
Also worth considering, say experts, is what effect, if any, the sudden rise in estrogen that occurs naturally during any pregnancy may also have when it occurs after a woman's own natural hormone levels have been dwindling, or even dormant, for quite some time.
"We don't know, for example, if being hit with a blast of estrogen after years of decreasing levels increases the risk of breast cancer or if fertility drugs further fuel that risk. Women deserve to know, but we just don't have the answer yet, " Smith tells WebMD.
The fact that some breast cancers are hormone-sensitive increases the importance of this issue. This means that tumors may develop, and certainly will flourish, in the presence of high hormone levels.
It's not known if Edwards' cancer is the hormone sensitive type -- and that information won't be known for a while. But if it is, Smith says there's an even greater possibility that her reproductive history and her breast cancer may be intimately entwined.
While the WHI study may have strengthened our fears about hormone therapy, unfortunately there is no parallel research confirming -- or denying -- our fears about fertility drugs. Indeed, studies conducted in the past produced some conflicting results, and that conflict continues. Research published as recently as April 2003 in the journal Sterility and Fertility offered new evidence that the fertility drug Pergonal may increase the risk of breast cancer in some women. As such, the researchers -- working under the auspices of the National Institute of Child Health and Human Development -- made a strong case for further study in this area.