Cancer treatment can be a long journey, extending over more than a decade when it involves hormone therapies to prevent tumor recurrence. For women who dream of becoming pregnant and discover breast cancer after age 35, this can be a turning point for fertility.
An international study, led by a scientist from Harvard Medical School and Dana–Farber Cancer Institute, both in the United States, was published on May 4 in the The New England Journal of Medicine and brings new hope to these patients. The researchers say that temporarily discontinuing endocrine therapy to try to conceive is safe and does not increase the risk of the disease returning.
It is the first time that a study evaluates the possibility of interrupting hormone therapy for patients trying to conceive. “This is a huge stress for women with breast cancer who are on endocrine therapy. Many are afraid that the tumor will return and this had never been evaluated in a direct way”, says oncologist Gustavo Fernandes, who was not involved in the research.
The physician and national director of Oncology at Rede DASA sees a promising future for the approach to breast cancer treatment. According to Fernandes, pregnancy is a very challenging phenomenon for the endocrine system and that could influence the tumor. Therefore, it has always been a fear of doctors and patients.
endocrine therapy
Endocrine therapy is an anti-hormonal treatment that reduces the action of estrogen in the woman’s body, decreasing the risk of tumor recurrence. It is indicated for patients with estrogen receptor positive breast cancer. Although some protocols admit a three-year protocol, the usual time varies between five and ten years.
Until then, it was recommended that patients wait for the end of endocrine therapy to try for a pregnancy. Thus, women who start the procedure at age 35 should wait until age 40 or 45 to try to get pregnant, making motherhood unfeasible for some.
Study
The study focused on women of reproductive age – up to 42 years old – and a history of stage one, two or three breast tumors (between early and advanced). They had received endocrine therapy for a period of 18 to 30 months (between one and a half and two and a half years) and were able to interrupt treatment to try to conceive.
Among the 497 women followed, 368 (74%) had at least one pregnancy. In all, 365 babies were born. At three years, the incidence of breast cancer events was 8.9% among those who stopped treatment and 9.2% in the control group.
It found that taking a break from treatment did not increase the risk of the cancer coming back in the short term, compared to women who did not stop therapy. Physicians highlight the need for long-term follow-up of patients to inform the safety of the approach.
“These results open a clear, comfortable and evidence-based window for young women diagnosed with breast cancer, undergoing complementary treatment, to interrupt treatment and try to conceive. It fills an incredible gap in the medical literature, brings a lot of security to the care and a possibility of fulfilling an important dream for the lives of many women”, says Fernandes.
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