In my introductory comments “Breast Cancer During Pregnancy - Overview” there were several important questions for which I have not yet offered answers. Each of these could be a blog unto themselves, but to keep things moving along, let me address several of these with simple bulleted comments:
• If I have had breast cancer treated before pregnancy, will pregnancy increase the risk of recurrence?: No. Pregnancy by itself does not appear to increase the risk of recurrence or poorer long-term prognosis above that expected by the type of cancer and the stage at detection and initiation of treatment. • Can breast cancer be transmitted to my baby?: I am not aware of any publications that suggest breast cancer can cross the placenta and affect the baby. Babies may be at greater risk for developing breast cancer during their lives for genetic reasons, but not as the result of ‘catching the disease’ from their mothers. • Can I breast feed my baby if I have had, or am undergoing treatment for, breast cancer?: There are several considerations for this question. First, if you are currently undergoing chemotherapy for breast cancer, then it is not recommended that you breastfeed. If you have completed chemotherapy, then you can consider breastfeeding. (Ask your breast specialist how long you should wait after completion of the chemotherapy that was chosen for your care). If you have had a large portion of a breast removed and/or had radiation therapy to a breast, then that breast may not produce much milk, although milk production by the remaining breast will usually be sufficient to support the baby at least in early infancy, if not longer. If you have chosen to defer therapy until after delivery, it is usually recommended that lactation be suppressed in anticipation of surgery, radiation, or chemotherapy. • If I have had breast cancer treated, how long should I wait before getting pregnant?: This depends on many factors, including stage of disease, response to therapy, type of therapy received, prognosis, and personal concerns (age, risk tolerance, desire for more children, etc…). The usual recommendation is that you wait at least two years after the diagnosis has been made before attempting conception. Recurrent disease often declares itself within this time frame. If you may be interested in pregnancy after a diagnosis of breast cancer has been made, you should bring that up with your physician when treatment options are discussed because certain chemotherapeutic agents, or pelvic radiation for metastatic disease, might impair future fertility. Technologic advances in assisted reproductive technologies are occurring daily and options for preservation of eggs or embryos should also be discussed with your providers if you would consider this and have the resources for the same.
I hope this series of posts has helped to answer many of your general questions related to breast cancer and pregnancy. If you have other questions that were not addressed, feel free to ask these in the comments section of this blog and I will do my best to respond. And, if I cannot answer a question myself, this is one topic on which I would be delighted to help you find an answer, even if it means referring the query to someone more expert in the field.