Ten-year follow-up confirms pregnancy after breast cancer is possible | ASCO 2024

Background

Astounding progress in breast cancer research has changed the way people diagnosed with breast cancer see their lives today and beyond. Early-stage breast cancer is often treatable, even curable. Yet doctors still have more to learn about the late effects of cancer treatment and their impact on health.

Fertility is a key concern for young women with breast cancer, who may ask their doctors: Will I be able to get pregnant? Will I give birth to a healthy baby? How will cancer treatment affect my fertility, pregnancy, or the health of the baby? What can I do to increase the chance of having a biological child?

Until now, the research in this area has been limited. Studies that tried to answer these questions did not follow people for enough time or ask about pregnancy plans prior to cancer treatment. These data are the first to be reported after 10 years of follow-up of women who, at diagnosis, were asked about their interest in having a baby in the future.

Results

This research showed that most women (73%) who tried to get pregnant after treatment for early-stage breast cancer were successful. Two-thirds (65%) of women in the study had at least one live birth. The average time from diagnosis to first pregnancy was two years, with a range of one to 10 years.

The study followed 197 women diagnosed with stage 0-III breast cancer over 10 years. They were white (80%), Asian (9%), Black (7%), multiracial (2%), or another race (2%). Six percent were Hispanic or Latino. All were part of the Young Women’s Breast Cancer Study, a large research effort that enrolled young women diagnosed with breast cancer at 13 locations in the U.S. and Canada between 2006 and 2016.

Participants in this fertility study were under 40 when they learned they had breast cancer. Their average age at diagnosis was 32. Most had hormone receptor-positive breast cancer treated with endocrine therapy and chemotherapy. Women with HER2-positive breast cancer (25%) and triple-negative breast cancer (17%) were included as well. The type of treatment they had did not affect their ability to get pregnant or have a live birth.

When the study team looked at factors that might affect pregnancy and giving birth, they found women who were diagnosed older were 18% less likely to get pregnant or have a live birth. In contrast, women who were financially comfortable were twice as likely to get pregnant. The biggest factor associated with having a live birth, however, was fertility preservation before starting cancer treatment. The 28% of the women stored eggs or embryos for future use were over 2.5 times more likely to have live births. However, the study author could not say whether they used their stored eggs or embryos. They are still analyzing the data and will report on that in the future.

What does this mean for you?

This study looked at many factors. The only one that predicted success in having a live birth was fertility preservation prior to treatment. Fertility preservation can take different forms. The women in this study froze their eggs or embryos, but it hasn’t yet been reported how or whether the eggs or embryos were used.

If you have been diagnosed with breast cancer and think you might want to get pregnant at some point, let your doctor know as early as possible. Ask to be referred to a fertility specialist to learn about options. You can also visit Breast cancer and fertility for more information.