Does breast cancer treatment affect fertility?

I am 33 years old and about to get married when I was diagnosed with breast cancer and had to undergo surgery and chemotherapy. After cancer treatment, will I be able to get pregnant and have children? (Tieu Vy, Dong Thap )

Reply:

Breast cancer is one of the most common types of cancer in women. Treatment options for breast cancer include chemotherapy, surgery, radiation therapy, and targeted therapy. Each method has a different impact on a woman's ability to conceive and have children.

If a patient undergoes only surgical removal of a breast tumor to treat cancer, without radiation and chemotherapy, it will not significantly affect their future fertility.

In cases requiring chemotherapy, breast cancer patients are at risk of premature ovarian dysfunction or early menopause. The ability to become pregnant after chemotherapy largely depends on the patient's age as well as the type and dosage of chemotherapy drugs used.

The later a cancer is diagnosed, the greater the likelihood of needing multiple chemotherapy drugs. High overall chemotherapy doses can increase the risk of infertility.

The younger the patient, the higher the chance of having children later. Women over 40 are more likely to experience menopause after chemotherapy. Chemotherapy can increase the risk of birth defects. Therefore, patients should use non-hormonal contraception such as condoms throughout chemotherapy to avoid pregnancy.

Doctor Anh Tuan (right) performs surgery on a breast cancer patient at Tam Anh General Hospital in Ho Chi Minh City. Photo: Provided by the hospital. — Doctor Anh Tuan (right) performs surgery on a breast cancer patient at Tam Anh General Hospital in Ho Chi Minh City. Photo: *Provided by the hospital.*

Women with breast cancer treated with hormone therapy may experience changes in their menstrual cycle, including amenorrhea (absence of menstruation) or cessation of ovarian production. Hormone therapy typically lasts at least five years, and patients should avoid pregnancy during this time. After hormone therapy ends, menstruation usually resumes, and pregnancy is possible.

Targeted therapy is less likely to harm healthy cells compared to chemotherapy. However, patients should wait at least six months to a year after treatment ends before becoming pregnant.

Young women with breast cancer may be prescribed ovarian suppression drugs. After completing treatment, patients can still become pregnant again.

Women who undergo radiation therapy to suppress ovarian function or have their ovaries surgically removed are affected in terms of fertility. If both ovaries are removed, the patient will no longer be able to conceive naturally. They can become pregnant through in-vitro fertilization (IVF) using donated eggs.

Before undergoing cancer treatment, patients are often advised by their obstetrician about egg freezing, to store healthy eggs, which can facilitate the process of having children after the treatment is completed.

In your case, you should inform your doctor about your pregnancy and childbirth plans before starting treatment so they can advise you on the most suitable treatment plan. You need to wait at least 6-12 months after your last treatment before getting pregnant.

Dr. Do Anh Tuan
Breast Surgery Department, Tam Anh General Hospital, Ho Chi Minh City

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