Breast cancer, while a daunting diagnosis, is increasingly treatable thanks to medical advancements. However, for women of reproductive age, treatment can often lead to fertility challenges. The connection between breast cancer and fertility primarily arises from the treatments used to combat the disease, which can impair ovarian function, damage eggs, or lead to early menopause. In this blog, we’ll explore breast cancer, its symptoms, causes, how treatment impacts fertility, and fertility preservation options for women who want to conceive after treatment.

What is Breast Cancer?

Breast cancer develops when cells in the breast tissue start growing uncontrollably, leading to the formation of a tumor. This tumor can be benign (non-cancerous) or malignant (cancerous), with malignant tumors having the ability to spread to other parts of the body. Breast cancer commonly starts in the milk ducts (ductal carcinoma) or the lobules (lobular carcinoma), but it can develop in other areas of the breast as well.

Symptoms of Breast Cancer

While breast cancer symptoms can vary from person to person, common signs include:
• Lump or thickening in the breast: One of the earliest signs of breast cancer is the presence of a lump in the breast or underarm area.
• Changes in breast shape or size: A sudden or gradual change in the size or shape of one or both breasts may be an indicator of cancer.
• Nipple changes: Unexplained nipple discharge, inverted nipples, or changes in the appearance of the nipple can be signs of breast cancer.
• Skin changes: Redness, dimpling, or a rash on the breast skin may indicate an underlying problem.
• Breast pain: While not always associated with cancer, persistent breast pain should be checked by a healthcare provider.
It is essential to perform regular self-examinations and consult with a doctor if any unusual changes are noticed.

Causes of Breast Cancer

The exact causes of breast cancer are not fully understood, but several factors increase the risk of developing the disease:
1. Genetic mutations: Women who inherit mutations in the BRCA1 or BRCA2 genes are at higher risk of developing breast cancer.
2. Age: The risk of breast cancer increases as a woman gets older, with most cases diagnosed in women over the age of 50.
3. Hormonal factors: Exposure to estrogen and progesterone, such as through early menstruation, late menopause, or hormone replacement therapy, can increase the risk.
4. Family history: Women with a family history of breast or ovarian cancer have an increased likelihood of developing the disease.
5. Lifestyle factors: Obesity, lack of physical activity, alcohol consumption, and smoking can all contribute to breast cancer risk.
While not all risk factors can be controlled, making healthy lifestyle choices and undergoing regular screenings can help with early detection and prevention.

How Breast Cancer Treatment Affects Fertility

Breast cancer treatment can significantly impact fertility, particularly for women of reproductive age. The effects vary depending on the type of treatment, the woman’s age, and the severity of the disease.
1. Chemotherapy and Fertility
Chemotherapy, a standard treatment for breast cancer, uses drugs to kill rapidly dividing cancer cells. Unfortunately, it also affects healthy cells, including eggs in the ovaries.
2. Radiation Therapy
Radiation therapy uses high-energy rays to destroy cancer cells. If the radiation is directed near the reproductive organs, it can harm the ovaries and lead to infertility.
3. Hormone Therapy
Hormone therapy is used to treat hormone receptor-positive breast cancers by blocking estrogen and progesterone, which fuel the growth of cancer cells.
4. Surgery
For some women, surgery is necessary to remove cancerous tissue. While breast surgeries like mastectomy don’t directly impact fertility, removal of the ovaries (oophorectomy) does.

Fertility Preservation Options for Women with Breast Cancer

For women diagnosed with breast cancer who wish to have children in the future, there are several fertility preservation options available. Ideally, these options should be discussed and initiated before cancer treatment begins.
1. Egg Freezing
Egg freezing, also known as oocyte cryopreservation, involves stimulating the ovaries to produce multiple eggs, which are then retrieved and frozen for future use.
2. Embryo Freezing
Similar to egg freezing, embryo freezing involves fertilizing the retrieved eggs with sperm before freezing them. This option is suitable for women who have a partner or are using donor sperm.
3. Ovarian Tissue Freezing
Ovarian tissue freezing involves removing and freezing a portion of ovarian tissue. After cancer treatment, the tissue can be transplanted back to restore ovarian function.

Navigating Fertility Decisions: What to Consider

Making fertility decisions during a breast cancer diagnosis can be emotionally challenging. Women facing these decisions should consider the following:
1. Consult a Fertility Specialist
Before starting breast cancer treatment, it’s crucial to consult with a fertility specialist. They can assess the risks and guide patients through fertility preservation options tailored to their specific situation.
2. Age and Timing
Age is a critical factor in fertility preservation. Women over 35 may face greater risks of fertility loss, and fertility preservation methods like egg or embryo freezing should be considered early.
3. Emotional and Psychological Impact
Fertility loss or uncertainty can take a psychological toll on women diagnosed with breast cancer. It’s important to seek emotional support through counseling, support groups, and open communication with loved ones.

Conclusion

While breast cancer treatment can impact fertility, there are options available to preserve reproductive health. By consulting with fertility specialists early in the treatment process, women can make informed decisions that prioritize both their cancer treatment and future family-building plans. Advances in fertility preservation, combined with personalized care from centers like Veramed Fertility and IVF Center, offer hope for women who wish to have children after their breast cancer journey.