Breast Cancer and Fertility Part 3: Pregnancy after breast cancer

Abstract

The incidence of breast cancer (BC) in young nulliparous women is on the rise globally. Early diagnosis and improved multimodality treatment have given survivors an opportunity to fulfill their reproductive needs. Concerns of disease recurrence, increased risk of antenatal and neonatal complications, and possibility of cancer inheritance in the baby influence decision making on pregnancy after BC (PAFBC). Fertility itself may be an issue as ovarian reserve is compromised by chemotherapy, and patient may need the help of assisted reproductive technique's. Fortunately, PAFBC treatment does not jeopardize disease outcome. However, the optimal time for conception after completion of treatment needs to be determined. Safety of pregnancy in women with a history of hormone (estrogen and progesterone) receptor positive BC, also remains controversial. Advice on going through with pregnancy should be individualized after evaluating the status of the women, keeping in mind safety of both fetus and the mother. Wishes of the patient need to be respected and the final decision rests with her.