Chemotherapy is known to have a negative effect on the reproductive capacity of women with new breast cancer. However, these effects after the end of chemotherapy have not been studied enough.
A new study, presented at ESMO 2018 (Congress of the European Society of Oncology) in Munich, confirmed that there may be normal pregnancies after chemotherapy, but showed that the desire of women – survivors of breast cancer – to have a child is significantly reduced after treatment, calling into question the need to systematically resort to fertility measures prior to initiating chemotherapy.
Fertility maintenance is currently based on the freezing of woman’s ova or embryos resulting from IVF. This procedure is usually followed in patients under 40 years of age who have breast cancer as suggested to them a few days after diagnosis.
Women in this age group account for less than 7% of total diagnosis for breast cancer worldwide. Those who survive – nowadays are many – have 70% fewer pregnancies than the general population.
In the study, 96 patients aged 18 to 40 years treated with chemotherapy for non-metastatic breast cancer participated, of whom 60 agreed to participate in the study. The mean age of the participants in the diagnosis was 36 years and the median time between the end of chemotherapy and study participation was 57 months.
In more than half of the cases, the cancer had spread to the lymph nodes at the time of diagnosis, which meant that it had a higher risk of relapse. All patients, however, were in full recession from the start of the survey. The results showed that 83% of the participants showed amenorrhoea – complete absence of menstruation – during their chemotherapy treatment.
“This was an expected finding,” said the study’s lead, Dr. Jérôme Martin-Babau from the Armoricain de Radiotherapie Center, Imagerie Médicale et Oncologie in Plérin, France. “What you did not expect was that 86% of the patients reported that their menstrual cycle returned to normal within the next year after the end of chemotherapy – an indication that the treatment did not completely affect their ovaries.”
What is also of great interest was how women’s desire to have children after chemotherapy evolved. More than one third of women reported having planned to become pregnant before they started treatment. On the other hand, only one in 10 said she still had a desire for childbirth after the end of her chemotherapy.