Among the many concerns following a breast cancer diagnosis is future family planning. Studies have shown that about half of patients of childbearing age would like to have a child after treatment. Because some forms of treatment can make it difficult to become pregnant, patients often choose to undergo fertility preservation. That may include freezing embryos, eggs, or ovarian tissue. Some patients voice concerns about impacts this could have on recurrence, however, due to hormones that can be involved in such procedures, as well as the fact that they may delay some treatments. A new study finds that patients may be able to breathe a bit more easily about these decisions, though.
Researchers at Karolinska Institutet in Sweden recently examined breast cancer recurrence and mortality figures among patients who underwent different types of fertility preservation and those who decided against it. The findings, published in the journal JAMA Oncology, found similar rates across the board.
Kenny Rodriguez-Wallberg, study co-author and research group leader at the university’s Department of Oncology-Pathology, says, “We did not see any increased risk of relapse or mortality when procedures for fertility preservation were undertaken, compared to the women who did not undergo procedures for fertility preservation. This is valuable information that can contribute to changed care routines when it comes to young women with breast cancer who want to preserve their fertility.”
To conduct their research, the team looked at data from nearly 1,300 women of childbearing age who had been treated for breast cancer between 1994 and 2017 in Sweden. Among them, 425 had opted for fertility preservation with or without hormonal stimulation. The researchers also included data from a control group of 850 patients who did not undergo such procedures. Members of both groups were matched based on age at diagnosis, the time that they were diagnosed, and their healthcare region. Overall, the women were followed for five years on average.
The team found that at the five-year mark, 89% of women who had undergone hormonal stimulation of the ovaries were recurrence-free, as were 83% of those who had frozen their ovarian tissue and 82% who had not undergone any fertility preservation procedure. The five-year survival rate was also 96% among those who had undergone hormonal stimulation to freeze eggs or embryos, 93% among those who had opted for fertility preservation without hormone stimulation, and 90% in those who had neither.
These findings help address a big concern for women who find themselves having to make reproductive decisions at a very stressful time.
Anna Marklund, first author and researcher in the Department of Oncology-Pathology, explains, “It is not unusual that women with hormone-positive breast cancer or their treating doctors opt out of the procedures for fertility preservation because of the fear that these procedures will increase the risk of cancer recurrence or death. In some cases, women are also advised to wait 5-10 years before trying to conceive, and with increasing age, fecundity in all women decreases. More knowledge is therefore needed about the safety of procedures for fertility preservation at the time of a breast cancer diagnosis.”
To further gauge their findings, the team plans to follow participants for another five years.
Other research has also shown that fertility preservation appears to be safe for young breast cancer patients and that many have gone on to successfully have children. If you want to understand your options and what they each entail, be sure to talk to your doctor.