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 continued...
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.
At the same time, however, Pisarska reminds us that other studies have shown no link to breast cancer. In addition, she says research shows that breastfeeding lowers a woman's overall risk, as does pregnancy itself, and, that other hormones present in the body during pregnancy may also reduce some cancer risks as well.
"Again, we're back to the idea that there are clearly no finite conclusions on this subject -- and we need more studies and we need more statistics, before we can accurately draw those conclusions," says Pisarska.
Protecting Your Breasts and Your Motherhood
While experts conservatively estimate it may be a decade or more before we have enough data to draw those accurate conclusions, doctors also say that older women seeking to get pregnant -- or those who already have -- need not feel frightened about pursuing their parenting dreams.
The reason: Tremendous breakthroughs in breast cancer prevention -- and the development of risk assessment programs so finely tuned, doctors can now intervene in a woman's personal health picture early enough to help her completely avoid breast cancer -- even if she is at increased risk.
To this end, Pisarska advises all her fertility patients over age 39 to get a mammogram prior to seeking any fertility treatments, or even trying to get pregnant on their own. If there is a strong family history of breast cancer, she recommends mammograms begin even younger.