Although it is rare for breast cancer to strike younger women, the fact
remains that all women are at risk. And for those of childbearing age,
the first sign and symptoms of breast cancer leading to a diagnosis can
not only be upsetting and unexpected, but complicated as well.
Developing breast cancer at a younger age—in a woman’s 40s, 30s, even
20s—will mean making important and difficult decisions about one’s life
and future perhaps much sooner than originally expected.
One concern is developing breast cancer during pregnancy, which
although rare, can still occur. In this case, the treatment chosen will
not only affect the patient and her body, but the growing baby inside
her as well. It will depend on what stage of pregnancy she is in
(first, second or third trimester) and what stage her cancer is in—such
as whether or not it’s advanced.
Most pregnant women can have treatment for their breast cancer without
affecting the baby. But some might be advised by their obstetrician or
health-care practitioner—or even decide themselves—to terminate the
pregnancy, more so if the pregnancy is in its earlier stages, in order
to receive certain treatments that would be too risky otherwise. But it
is essential to remember that it is a woman’s own decision—it is not
medically necessary to terminate a pregnancy if the expectant mother is
diagnosed with breast cancer. All it does is limit treatment options.
Breast cancer itself will not affect the fetus—only certain tests and
treatments will.
Generally speaking, tamoxifen, chemotherapy, radiation, and other
drug-related therapies are avoided if the woman is pregnant because of
their associated risks with birth defects. Tamoxifen, especially, is
considered very unsafe because it is a hormonal therapy and is never
recommended if the woman is pregnant or planning on conceiving.
Surgery—either a lumpectomy or mastectomy—is the most common and
preferred method of treatment for breast cancer in pregnant women.
Another concern is whether or not breast cancer survivors can or should
go on to have children after treatment and recovery. It’s a very
controversial issue with firm advocates on both sides of the debate.
There are two main questions here, for both the medical and health
community and breast cancer survivors wanting their own children: 1) Do
certain breast cancer treatments affect fertility?; and 2) Is it
actually considered safe to conceive and carry a baby to term following
breast cancer and breast cancer treatments?
As far as fertility goes, there is no definite answer here. For
chemotherapy, it depends on the age and what specific drug was
used—some affect fertility more than others. And taking tamoxifen after
chemotherapy to prevent recurrence is not recommended if the woman
desires to become pregnant right away. Although tamoxifen is sometimes
used as a fertility treatment, there is evidence to suggest that it
damages developing embryos, and therefore is not considered safe to use.
Many doctors caution these women to wait several years to ensure
receiving the best breast cancer treatment possible and to go past the
point of the biggest threat of breast cancer recurrence. But some women
decide to go ahead and have babies anyway, since it’s so important to
them.
