On a positive note, for women who successfully achieve pregnancy after breast cancer, pregnancy outcomes appear to be similar to those of their nonpregnant peers. In the study by Azim and colleagues, women who became pregnant after a breast cancer diagnosis had disease-free survival that was statistically similar to that of matched women who did not have subsequent pregnancies. In addition, this outcome did not differ based on estrogen/progesterone receptor status (ER/PR positive or negative).
WHAT THIS EVIDENCE MEANS FOR PRACTICE
Both alkylating chemotherapeutic agents (eg, cyclophosphamide) and selective estrogen receptor modulating agents (for women with estrogen-receptor–positive tumors) are routine parts of adjuvant treatment for premenopausal women with invasive breast cancers.
These agents can have profound effects on both ovarian hormonal function and fertility. ObGyns and reproductive endocrinology/infertility specialists have a great opportunity to partner with our oncology colleagues to enhance the counseling that young women receive before, during, and after breast cancer treatment.
Women who are considering future childbearing should receive information about the impact of breast cancer treatment on fertility and options for fertility preservation prior to initiating treatment. For women who have completed childbearing, information on what to expect if menopause occurs and available options for symptom relief can be empowering as they make treatment decisions.
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