Yes, it is possible for you to get pregnant after breast cancer treatment.
However, some chemotherapy may affect your ovarian function, in turn reducing your chance of having a baby. Some women may run into early menopause after chemotherapy. The effect of chemotherapy varies, and will depend on your age, your ovarian reserve, the type of chemotherapy and the dosage used.
Other drugs (for example, tamoxifen and Herceptin) do not appear to affect your future chance of pregnancy, but you should avoid getting pregnant while taking them because they may harm the baby.
It may be possible to freeze your eggs (possible for single women) or embryos (if you are married) before your chemotherapy begins.
This involves medication to stimulate your ovaries to produce more eggs, followed by a minor surgical procedure to get the eggs through the vagina. These usually take around 2-3 weeks. The frozen eggs or embryos can be used to make you pregnant if you cannot get pregnant naturally in the future. The fertility specialist will consider medications (letrozole) to lower the estrogen level during the treatment process, so that the procedure will not increase the recurrence risk of your breast cancer.
The chance of successful pregnancy depends on your current age and the number of eggs/embryos frozen.
If you may have plans for future pregnancies, talk to your breast cancer specialist, who can refer you to a fertility specialist to discuss about egg or embryo freezing.
Further information about egg and embryo freezing can be found at the website of The Centre of Assisted Reproduction and Embryology, The University of Hong Kong-Queen Mary Hospital (HKU-QMH CARE): https://hkuivf.hku.hk/en/services/fertility-preservation/female/
Some women would consider having GnRH agonists (injection every 1-3 months) during chemotherapy to suppress their ovaries to protect them from the effects of chemotherapy. Side effects are similar to menopausal symptoms, such as hot flushes, mood changes, difficulty sleeping and vaginal dryness. However, there is no sufficient evidence that this method will definitely protect your ovaries. You may still develop early menopause and infertility despite using these drugs. Talk to your breast cancer specialist if you would like to consider this drug.
Always speak to your breast cancer specialist before trying to get pregnant. You will usually be advised to wait for at least 2 years after your breast cancer treatment has finished as this is when breast cancer most likely to recur. It will be more complicated if cancer recurs during pregnancy because diagnosis may be delayed, and treatment choices are more limited.
If you are taking Tamoxifen, you should avoid pregnancy till at least 9 months after stopping it because it may harm the baby. For Herceptin, you should wait till at least 7 months after stopping it before you try for pregnancy. Do not stop any treatment without first discussing that with your doctor.
No, pregnancy will not increase the chance of recurrence of breast cancer. But always speak to your breast cancer specialist before you try for pregnancy.
Surgery or radiotherapy to the breast may cause problem with milk production in that breast, but the other breast will not be affected. You can still breastfeed your baby. Speak to your obstetrician and midwife, who will support you on breastfeeding. Breastfeeding will not increase the recurrence risk of breast cancer.
However, if you are still receiving chemotherapy, tamoxifen or Herceptin, you should not breastfeed.
In general, women who have history of breast cancer should not use hormonal contraceptives such as the pill and injectables because they may stimulate breast cancer cells to grow. Non-hormonal contraceptives such as condoms or copper intrauterine contraceptive devices would be good choices for you. Talk to your doctor if you want more information.
In general, having a breast removed should not affect your sexuality. However, some women might lose confidence because breasts are an importance sexual characteristic. You may feel upset about the change in your appearance and may potentially lose interest in sex. You may also be worried that your partner will not accept your new look.
The diagnosis and treatment of breast cancer can have a great impact on you, and on your partner as well. It is important to talk to each other about your feelings and needs. You can express your love for each other by talking, hugging and caressing each other’s bodies. When you feel more relaxed, move on to touching the breasts and genitals. If you have pain during sex due to dryness in the vagina, consider using lubricants.
If you encounter sexual problems that bother you, talk to your doctor, a psychologist or sex counsellor.
More information on sexuality in cancer patients can be found in a booklet “Intimacy, Sexuality & Fertility” published by The Hong Kong Cancer Fund (Chinese version only):
“Intimacy, Sexuality & Fertility”
Written by: Dr YUNG Shuk-Fei Sofie, Department of Obstetrics and Gynaecology, the University of Hong Kong
