Young women diagnosed with breast cancer often have to delay pregnancy for years while taking hormone-blocking pills. A reassuring new study has found that women can take a two-year break from these drugs to get pregnant without increasing their short-term risk of the cancer returning. “This is really good news for young women and their doctors and their families,” said Dr. Ann Partridge of the Dana-Farber Cancer Institute in Boston, who led the study. The results were discussed Thursday at the Breast Cancer Symposium in San Antonio.
Although breast cancer is more common in older women, it is increasingly being diagnosed during childbearing years for reasons that are not clear. For patients whose cancer is driven by hormones, treatment involves surgery, then spending five to 10 years on hormone-blocking drugs that can cause birth defects, or newer drugs called aromatase inhibitors, and monthly injections to shut down the ovaries.
Partridge estimates that 6,000 American women a year want to get pregnant but have to take hormone-blocking drugs.”They don’t want to hear about breast cancer again, but they also don’t want to put their lives on hold,” she said. The study followed 516 women after surgery for early-stage cancer. All then spent at least 18 months on hormone-blocking drugs. Women stopped hormone blockers for up to two years to get pregnant, give birth and breastfeed. They then restarted cancer treatment.
After three years, about 9% had their cancer return, similar to a similar group of women in a separate study who remained on hormone-blocking therapy. There were nine deaths, “below the expected rate for this population,” Partridge said. As part of the study, more than 300 children were born to the women. Among them was Amy Bianchi’s son Brayden, now 4. “He’s perfect in every way,” Bianchi said. “I couldn’t imagine my life without him. We couldn’t imagine our family without him.”
Bianchi felt a lump that turned out to be breast cancer when her firstborn, Mia, was 18 months old. Doctors advised against another pregnancy, but she learned about the research and signed up. “If I had listened to the first few doctors or oncologists I talked to, I would have lost all hope,” said Bianchi, 42, of Niskayuna, New York. “I would accept very quickly that I would never have the family I envisioned. She managed to breastfeed her son for six months before restarting the hormone blockade, which she will continue until 2026. Researchers will follow Bianchi and other study participants and report on long-term safety. “Will we see a difference in 10 years?” asked Dr. Hope Rugo of the University of California, San Francisco, who was not involved in the study. “For the moment, these are incredibly encouraging data. It should give doctors and patients confidence” when discussing ways to benefit from cancer treatment while starting a family.
