Pregnancy And Breastfeeding After Breast Cancer

Breast cancer is cancer that originates in the breast and might spread to other parts of the body. In 2020, 2.3 million women worldwide were diagnosed with breast cancer, with 685,000 fatalities. Breast cancer has been diagnosed in 7.8 million women in the previous five years as of the end of 2020, making it the most common disease amongst women in the world. Its survival rate ranges from more than 90 per cent in high-income nations to 66 per cent in India five years after the diagnosis. Breast cancer is more frequent in women in their forties and fifties. Early-stage breast cancer is cured with a combination of surgery, radiation and in some cases, medicines.  

Younger women with early detection of breast cancer may wonder how it will influence their ability to have children and whether there are any additional complications. Following breast cancer therapy, many women are able to conceive, although certain therapies might make it more difficult to conceive. Patients who have undergone chemotherapy are at risk of experiencing premature ovarian failure or menopause, thus resulting in infertility. This is because chemotherapy can kill healthy cells, including ova, in addition to the malignant tissues. However, even after treatment, many women are able to conceive. 

Future reproductive concerns have become a major topic in the consultation and treatment of newly diagnosed young cancer patients. Before setting on a treatment for cancer, patients are consulted on their plans to have children. Of the several fertility preservation methods available, the most well-known is ovarian stimulation followed by in vitro fertilisation (IVF) and embryo cryopreservation, which is particularly useful in breast cancer patients in their reproductive years. In the absence of a partner, breast cancer patients can also choose to cryopreserve their ova, also known as egg freezing, to plan their family after beating the disease. In both techniques, embryos and eggs are stored in liquid nitrogen for up to 10 years, by law, and can be used to conceive. 

A cancer survivor may have to go through tests like ultrasound of the ovaries and uterus, as well as a range of blood tests to determine the levels of follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH), among others. These tests help ascertain the fertility conditions of the survivor, and if assisted reproductive technology interventions will be required.

It is advised that women should wait for at least two years before trying to conceive after the completion of breast cancer treatment. This is because the chance of the cancer returning decreases with time, and one may be most vulnerable in the first two years following diagnosis. Being in touch with a fertility expert and an oncologist can prove to be helpful in making an educated decision regarding this. One might want to talk about their personal risk of recurrence, as well as other pertinent factors like age and what treatments they have received.

Many mothers are able to nurse their children after breast cancer treatment. However, one may face difficulty nursing from the affected breast if they have had breast surgery or radiotherapy. Reduced milk supply as well as anatomical changes in the affected breast have been reported in studies ; this might make nursing uncomfortable or make it difficult for the infant to latch onto the breast.

Breastfeeding is harmless for the mother and the baby if the mother is not undergoing chemotherapy while nursing or using long-term medications like tamoxifen – an aromatase inhibitor or trastuzumab. Some medications can pass into the breast milk and harm the infant. Thus, it is advisable that before attempting to breastfeed, one should speak with their doctor in case they are on any medication to treat breast cancer.

Dr Kshitiz Murdia

Guest Author The author is CEO and Co-founder of Indira IVF