Topic: Pregnancy after ER positive breast cancer

Forum: Young With Breast Cancer — Connect with those under 40 who have been diagnosed.

Posted on: Feb 17, 2016 11:34PM - edited Feb 17, 2016 11:36PM by LM070917

Posted on: Feb 17, 2016 11:34PM - edited Feb 17, 2016 11:36PM by LM070917

LM070917 wrote:

Just wondering if there are many ladies out there who have become pregnant after being diagnosed with ER positive breast cancer and how long you waited after being diagnosed?

I know docs generally say to wait 2-3 years after treatment, but being ER positive, I also hear it can be risky in terms of recurrance

I am 35 years old with no children and 90% ER, 20% PR positive. I have two frozen embryos.

I have looked at adoption, but many agencies seem prejudice against women with a history of cancer.

Dx 9/18/2015, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/14 nodes, ER+/PR+, HER2- Chemotherapy 11/1/2015 AC + T (Taxol) Surgery Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Radiation Therapy Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin)
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Mar 20, 2016 04:48PM laura_ingalls wrote:

dear Lottemarine,

i was just diagnosed 10 days ago. i am aiming for fertility preservation before i start chemo. i haven't been able to get an appointment with an oncologist yet. could you please share any advice or tips on fertility preservation before chemo? thanks so much and good luck!

laura*


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Mar 20, 2016 08:00PM kiwikid wrote:

Hey I was dx in 2012. I did 2 years on tamoxifen and zoladex then stopped to try for a baby. One oncologist told me that the risk does not increase during pregnancy, the other said it goes up slightly. They both said that the long term survival is better for women who go on to have a baby after BC. Im now 13 weeks pregnant with my first, at 37!!

Age 34 Dx 11/14/2012, IDC, 1cm, Stage IB, Grade 1, 1/4 nodes, ER+/PR+, HER2- Surgery 11/21/2012 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 12/29/2012 AC Hormonal Therapy 3/25/2013 Surgery 4/14/2013 Mastectomy: Left; Reconstruction (left)
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Mar 20, 2016 08:17PM kiwikid wrote:

copied is site


Pregnancy After Diagnosis Doesn't Seem to Affect Recurrence Risk Save as Favorite

It's estimated that there are about 400,000 breast cancer survivors younger than 45 in the United States. Many of these women might want to have children, but some doctors have been concerned that getting pregnant after a breast cancer diagnosis might affect the risk of breast cancer coming back (recurrence). This is because hormones can promote the growth and spread of breast cancer, and during pregnancy, hormone levels change.

Many women who get pregnant after a breast cancer diagnosis end their pregnancies because they've been told it would reduce their risk of recurrence, especially if they had been diagnosed with hormone-receptor-positive breast cancer and got pregnant within 5 years after diagnosis – getting pregnant would have meant their hormone therapy treatment would have been interrupted.

A study suggests that women who get pregnant after being diagnosed with breast cancer have the same recurrence risk as women who don't get pregnant after being diagnosed, no matter the hormone-receptor status of the breast cancer.

The research was published online on Nov. 19, 2012 by the Journal of Clinical Oncology. Read the abstract of "Prognostic Impact of Pregnancy After Breast Cancer According to Estrogen Receptor Status: A Multicenter Retrospective Study."

The study matched 333 women who became pregnant any time after a breast cancer diagnosis with 874 similar women who didn't get pregnant after diagnosis. The women were similar in terms of:

  • cancer hormone-receptor status
  • number of lymph nodes involved
  • type of treatment(s) after surgery
  • age
  • year of diagnosis

The researchers found that there was no difference in the risk of recurrence between the two groups of women. Even when the researchers looked at only women diagnosed with estrogen-receptor-positive disease and only women diagnosed with estrogen-receptor-negative disease, there was no difference in recurrence risk.

The researchers also compared the recurrence risk of women who ended their pregnancies (30% of the women) to women who went full-term and delivered babies. There was no difference in recurrence risk between these two groups of women. So there is no reason to tell women who've been diagnosed with breast cancer that ending a pregnancy after diagnosis will reduce their recurrence risk.

Interestingly, the researchers found that women who got pregnant after a breast cancer diagnosis had better overall survival than women who didn't get pregnant after being diagnosed. This benefit also was independent of the cancer's hormone-receptor status. Overall survival is how long a woman lives, with or without the cancer coming back.

It's not clear why the women who got pregnant had better overall survival. It could be that the better overall survival was due to better overall health and not because of being pregnant. So we can't conclude from this study that pregnancy after breast cancer improves survival. But the good news is that pregnancy doesn't negatively affect recurrence risk or future survival in women who've been diagnosed.

This study was a retrospective study, which means the researchers analyzed information that had been collected before the study was designed. Retrospective studies aren't considered as good as studies that are designed first and then collect new information specifically for that study.

If you're currently being treated for breast cancer or have been treated in the past and think you might want to become pregnant in the future, this study is reassuring. It suggests that you can get pregnant without affecting your risk of recurrence or survival, no matter the hormone-receptor status of the cancer. You can learn more about fertility issues and planning for children after breast cancer treatment in the Fertility and Pregnancy Issues During and After Breast Cancer pages in the Breastcancer.org Day-to-Day Matterssection. elsewhere on

Age 34 Dx 11/14/2012, IDC, 1cm, Stage IB, Grade 1, 1/4 nodes, ER+/PR+, HER2- Surgery 11/21/2012 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 12/29/2012 AC Hormonal Therapy 3/25/2013 Surgery 4/14/2013 Mastectomy: Left; Reconstruction (left)
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Mar 30, 2016 06:26AM chinesewoman wrote:

Hey, laides, I am 36, married for only 1 year and have no children, I started my tamoxifen today.

I did quite some research on the topic, it is said that doctors usually ask patients to wait for 2 or 3 years not because pregnancy increases the risk of recurrence but that most recurrences happen in about 2 years, you may want to make sure the cancer does not come back before you get pregnant.

My doctor asks me to take tamoxifen for 1 or 2 years and wait 6 months (to detoxify my body) and then see if I can get pregnant.

Wish us good luck.

Dx 8/12/2015, IDC, Right, 3cm, Stage IIA, Grade 3, 0/5 nodes, ER+/PR+, HER2- Surgery 8/21/2015 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right) Chemotherapy 9/17/2015 AC + T (Taxol) Hormonal Therapy 3/29/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 4/17/2018, Stage IV, metastasized to bone/lungs
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Apr 1, 2016 02:00AM LM070917 wrote:

Thanks ladies, it's good to hear it doesn't necessarily increase the risk of recurrance. Yeah it sounds like 2-3 years out is the way to go.

Hey Laura, so sorry to hear you've been diagnosed. I had IVF after my mascretomy but prior to chemo. I had to inject myself with estrogen and another drug to counteract it for 2 weeks to get my follicles ready for egg collection. Apparently the drugs I was injecting only slightly increased my estrogen levels. I then had a very quick operation (20 mins max) so they could collect the eggs. My husband and I opted for embryos to be frozen, which from what I hear is more successful than just freezing eggs on their own. It can be quite a trying period, because I had one ovalating cycle to basically see how many embryos I could get, but we got 2 in the end so I was pretty happy with that. It's totally worth doing though, as you don't know how chemo will effect your fertility. I also took zoladex prior to starting chemo and throughout, which temporarily shut down my ovaries to protect them from the chemo drugs.
Dx 9/18/2015, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/14 nodes, ER+/PR+, HER2- Chemotherapy 11/1/2015 AC + T (Taxol) Surgery Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Radiation Therapy Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin)
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Apr 1, 2016 02:08AM LM070917 wrote:

Congratulations kiwikid, that's great news! And gives all of us hope for the future 😀 Hope all goes well with your pregnancy!
Dx 9/18/2015, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/14 nodes, ER+/PR+, HER2- Chemotherapy 11/1/2015 AC + T (Taxol) Surgery Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Radiation Therapy Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin)
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Apr 10, 2016 09:39AM christina0001 wrote:

I was diagnosed at 32, completed treatment at age 33 other than taking tamoxifen for a year, until I was 34. I had my first baby last year at age 36 and I have another one due this September (I'll be 37). I didn't wait that long on purpose; it just took that amount of time to meet Mr. Right. We were able to conceive naturally despite all the chemo. I feel like our family will be complete after two babies and I'll probably go back on tamoxifen after this baby arrives if my onc recommends it.

My oncologist recommended not getting pregnant. Research in this area seems very limited and mixed and his personal thought is that it could increase the risk of reoccurrence. I'm not convinced either way. But, I went through all those treatments so I could live my life, and that's what I'm doing.

Good luck to you!

Surgery 1/10/2012 Lumpectomy: Right Dx 1/16/2012, IDC, 2cm, Stage IIA, Grade 3, 0/7 nodes, ER+/PR+, HER2+ Surgery 2/9/2012 Lymph node removal: Right, Sentinel Targeted Therapy 2/12/2012 Herceptin (trastuzumab) Chemotherapy 2/12/2012 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 8/9/2012 Mastectomy: Right Hormonal Therapy 8/23/2012 Radiation Therapy 9/30/2012 Breast Surgery 7/29/2013 Reconstruction (right): DIEP flap
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May 2, 2016 10:47AM laura_ingalls wrote:

thanks for the great input everyone.

Lottemarine: thanks for the details on the ivf cycle.

i finished my cycle (it was very stresfull!) and am waiting to be reunited with my frozen embryos someday in the future hopefully! chemo for me this week if all goes well.

*

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May 4, 2016 07:44AM Mabs wrote:

Hi Girls, I was dx in 2014 with stage I IDC, Pr and Er 90% positive, and right now I am currently on tamox and zoladex (to have my ovaries shut down).

I have a baby girl, born in 2012, and I want to have one more baby, after my 5 years of tamox, to complete my family!

I was undergoing a check up to ger pregnant again when I was dx, so it postponed my dream of having another baby...

Sometimes I feel very scary of getting pregnant again, for the same reasons as you... So always good to hear similar stories...

Wish you all the best!!!

Dx 8/2014, IDC, Left, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/31/2014 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left); Reconstruction (right) Hormonal Therapy 11/2/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin)
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May 9, 2016 09:43PM laura_ingalls wrote:

ladies. My onco would not offer ovarian suppression during chemo since my cancer is estrogen positive. I was told the same by dr wolf at Johns Hopkins when I sought a second opinion: ovarian suppression can affect the effect of chemotherapy on estrogen positive cancer. I heard this twice from two different oncologists but I can't find anything on Google about this.

Anyways...anyone else have their onco refuse to do ovarian suppression? I don't want to lose out on potential fertility by skipping ovarian suppression.

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