World Breast Cancer Awareness Month.
October is World Breast Cancer Awareness Month. This annual international campaign emphasizes early detection and tries to raise money for research. Breast cancer is the most common type of cancer in women, both in developed and in developing countries.
Dr. Consuelo Sanz, one of the Gynecologists at ProcreaTec, is also the Director of the Breast Pathology Unit at the 12 de Octubre Hospital in Madrid. We asked her a few questions about her sub-specialization in relation to fertility.
We asked her if assisted reproduction treatments produce breast cancer.
She responded, “Currently, there is no scientific evidence that shows that fertility treatments cause breast cancer or any other type of cancer for that matter. It is important to note, however, that when beginning a hormonal treatment of any kind, an in-depth medical history is required, as well as a gynecological examination, which should include a breast exam. From the age of 40 onwards, we require, prior to fertility treatment, a mammogram or breast scan.”
Another question that is often asked is if one can undergo an assisted reproduction treatment after breast cancer? How long should one wait?
Dr. Sanz responded, “The available studies do not show that the chances of pregnancy are affected by having had breast cancer. With regards to the amount of time that one should wait after having had cancer, it depends. The possibility of getting pregnant should always be discussed between the patient and the medical team that treats her (namely the oncologist and the surgeon). The ideal time will depend on the molecular type, the stage and the age of the patient. In general terms, however, we could say that a woman who has had breast cancer should wait two years to get pregnant from the time she finished the cancer treatment. This is due to the fact that if a relapse were to occur, it almost always happens within these two years.”
We went on to ask if a patient’s prognosis is affected if she preserves her fertility after being diagnosed with breast cancer?
“Fertility preservation has no effect on a patient’s prognosis and, many times it is the only opportunity for the patient to have a child with her own eggs. It is for this reason that breast cancer patients who want to be parents should be informed of this option prior to beginning chemotherapy treatment. It is also important to note that the treatment used to stimulate the ovaries, does not have an effect on the offspring. All these recommendations are in the safe and good practice clinical guides published by scientific associations. These recommendations are also published by Royal Spanish decree printed in 2014 in the Spanish National Official Bulletin (Boletín Oficial del Estado).
What fertility preservation options do patients have?
There are three main options:
1. The use of GnRH analogues. This medication leaves the ovaries in “resting mode”, so that chemotherapy and radiotherapy do not affect the eggs. By administering this medication, an “artificial menopause” is induced, which protects the ovaries. Nowadays, however, this technique is not usually the first alternative.
2. In a quasi-experimental way, the ovarian tissue is preserved and later transplanted.
3. Egg Freezing: In this treatment, the patient undergoes an ovarian stimulation so that, instead of only one egg maturing (which is what naturally happens every cycle), the maximum number of eggs mature, so they can be retrieved and preserved for future use.
Dr. Sanz concluded by telling us that the month of October is her favorite month of the year because it is a time when both women and men are made aware of the importance of early detection and that, the earlier a cancer is detected, the higher the probability of curing the disease.
In this month of World Breast Cancer Awareness, ProcreaTec stands together with all those affected by breast cancer: patients, family, friends and supports the medical personal who dedicate their lives to curing the disease.