On the occasion of International Breast Cancer Day, we want to talk about the preservation of fertility when suffering from breast cancer or about the direct impact that pregnancy could have on the development of this disease in women. This is all you have to know if you want to get pregnant after having breast cancer.
Breast cancer ranks as the second most prevalent in Spain. According to the Spanish Association Against Cancer (AECC), between 2012 and 2018 there was an increase of 30% in patients affected by this pathology, with 25,212 new cases in 2012 and 32,825 cases in 2018. The breast cancer In Spain, it has a 5-year survival rate higher than 90%, that is, 90 out of 100 patients are still alive 5 years after being diagnosed with this pathology.
During breast cancer treatment and, subsequently, for a certain period that will depend on the type of tumor and its evolution, the patient is not advised to become pregnant, but there are certain issues that a patient with this pathology and who wishes to become a mother later must know.
On the one hand, chemotherapy produces an alteration in the functioning of the woman's ovaries, due to the damage to the ovarian tissue caused by the drugs used in said treatment. Depending on the drug, the age of the patient and the severity of the tumor, the damage may be greater or less and fertility will be affected or not. However, Unless the patient suffers irreversible ovarian damage, there could be the possibility of becoming pregnant once the cancer has overcome.
Currently, less than 10% of breast cancer survivors decide to become pregnant, either out of fear, lack of information or of their own choice. In this way, and considering that many of the therapies used can cause this incidence in the ovary, more and more women choose to preserve their fertility before starting treatment.
Thus, among the various options available can be found the vitrification of oocytes for subsequent in vitro fertilization, ovarian tissue freezing or embryo cryopreservation (This requires that the patient have a partner or resort to a sperm donation at the time of diagnosis).
Both embryo and oocyte cryopreservation require prior ovarian stimulation through the ingestion of certain medications with hormones, which stimulate the ovaries to produce an adequate number of oocytes to facilitate the use of assisted reproductive techniques. This treatment is carried out as long as the oncologist responsible for the patient gives the authorization to delay the start of the oncological treatment by 15-20 days.
The case of cryopreservation of the ovarian cortex (which consists of reimplanting the previously frozen tissue) is less effective than the previous two, but it does not require any type of hormonal stimulation or delay the patient's cancer treatment. This treatment is also indicated above all in cases of very young cancer patients.
Breast cancer is difficult to detect during the gestation period. Throughout pregnancy, women undergo physiological changes that make it difficult to see clearly the appearance of abnormal masses in the breast, thus delaying the diagnosis of cancer.
However, it is necessary to clarify that pregnant women are not more likely to get breast cancer for the simple fact of being in a state of pregnancy and, in general, the fetus does not usually contract the disease because its mother suffers from it.
The treatment that is usually carried out depends on the type of tumor and each case is treated in a personalized way. Gynecological examinations and the antecedents in the patient's medical history mean that patients are increasingly controlled and oncological processes are detected earlier.
Treatment of breast cancer during pregnancy is a complex process as it compromises the situation of the mother and the fetus. Deciding on one treatment or another will depend on the situation in which the tumor is found (if it is located only in the breast or if it has spread to other organs), its size, the age of the fetus, the health of the patient, its age… However, it is essential to know exactly each case in particular and offer the best option available for each patient.
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