When a woman is diagnosed with breast cancer, she not only worries about whether or not she will survive the battle against this dreaded illness. Especially in those women of childbearing age and have yet to have a baby, they are worried that the cancer and its treatments may have an effect on their fertility.
It should first be emphasised that most women are able to have a baby even with breast cancer. No evidence has been found that the cancer will have a negative effect on the baby’s growth and development or that the cancer will be passed on to the fetus while inside the womb. The only way for breast cancer to be passed on is if there is a strong family history and if the mother, siblings and other first degree female relatives have the gene for the cancer.
However, what will definitely affect fertility is the breast cancer treatment.
Three Factors that Determine the Effects of Breast Cancer Treatment on Fertility
There are three factors that determine the effects of breast cancer treatment on fertility, namely the type of treatment, the type and stage of cancer at the time of diagnosis, and the patient’s age. Let us discuss these factors one by one…
Type of Treatment
Of the three types of treatment for breast cancer, surgery with radiation therapy has the least impact on fertility, with the notable exception of a cancer that has spread to the ovaries and would require surgical removal. But this is very rare.
Chemotherapy has the greatest impact on fertility, with a percentage of risk ranging between 40 and 80 percent. With chemo, there is an increased risk of menopause occurring much earlier and premature ovarian failure. Of the four chemotherapeutic agents being used, cyclophosphamide poses the greatest risk for ovarian failure.
Type and Stage of Cancer
The need for chemotherapy is dependent upon the type and stage of the breast cancer when it is detected.
For localized tumours, they will only require surgery with radiation therapy or the hormone-containing drugs, which have minimal effect on fertility.
However, if the tumour is found to be “hormone insensitive”, chemotherapy is necessary. Cancers found to be advanced stages or the invasive type would also require systemic chemotherapy, and will thus affect the entire body including the reproductive system.
Patient’s Age
Patient’s age when chemotherapy is instituted is a significant factor in determining fertility as well. Women who are 30 years old and above, do not have a child, and need chemotherapy to treat their breast cancer are in a double jeopardy position because their fertility is already in a state of decline and it will be aggravated by the effects of the chemo.
How To Preserve Fertility
If diagnosed with breast cancer prior to having a baby, you may need to look into ways by which you can preserve fertility.
One way is by freezing embryos that have been created through In Vitro Fertilization (IVF). If breast cancer is not to be instituted immediately, you can have your embryos frozen through IVF (although it is a lengthy procedure taking three to four weeks) while sperm is obtained from your spouse or a donor.
Some breast cancer patients/ survivors have seen their fertility restored with Tamoxifen, which stimulates the ovaries and enhances egg and embryo production during the course of IVF.
