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First trimester

Pregnancy and breastfeeding after cancer

31 May 2021 | By Robyn MacLarty

For breast cancer surviviors, the choice to conceive a child is an exciting and sometimes scary one. But it’s still possible to have a healthy pregnancy.

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You’ve survived the unimaginable, and for those with hopes of becoming a mother (or adding to your brood), being a breast cancer survivor can bring with it a unique cocktail of challenges, from fears around remission to whether your body will be able to conceive, carry your child to term, or breastfeed.

The bad news is that breast cancer survivors are less likely to fall pregnant than the general public. The good news is that, if you do fall pregnant, and follow the guidelines of your oncologist and OB/GYN, there’s a good chance you’ll be capable of carrying a child to term. 

While it’s true that there are risks particular to breast cancer survivors – you may face a higher risk of certain complications such as preterm labour, for example – most survivors who do get pregnant deliver healthy babies and there are no adverse effects on their long-term survival, according to The American Association for Cancer Research.

Before you conceive

“The subject of pregnancy and motherhood is a discussion that should be had with your oncologist before your treatment even begins,” says Dr Liana Roodt, a specialist general surgeon and a surgical consultant in the Surgical Breast and Endocrine Unit and the trauma centre at Groote Schuur Hospital, Cape Town. 

“If it is something you desire, the recommendation is usually to freeze your eggs before chemotherapy begins, so you have the best chance of conceiving later on.”

She adds that, for estrogen-sensitive cancers, pregnancy (an estrogen storm!) needs to be planned, and a survivor should avoid falling pregnant until at least five years after the cancer has gone into remission. 

“You need to give your body the best possible advantage for a healthy pregnancy. Research has found that falling pregnant less than two years after remission can increase the chances of a recurrence. Five years is generally considered safest.”

If for some reason you didn’t discuss pregnancy with your oncologist during your treatment, make sure they’re aware of the good news right from the get-go. Your oncologist should be as integral a part of your pregnancy team as your OB/GYN, with regular check-ups along the way. 

“Your relationship with your oncologist here is key,” says Dr Roodt. “But apart from that, it’s crucial that you follow all the usual guidelines for a healthy pregnancy: get enough rest, good nutrition, etc.”

What about breastfeeding?

As you probably know, after a tumour has been removed from your breast/s, breastfeeding will no longer be possible. However if only one breast was affected by cancer, and the other breast was not, you may well be able to breastfeed in this way.

“Usually, women are concerned about the consistency of their breasts changing during pregnancy and before weaning, which can happen due to lactation,” says Dr Roodt. “For this reason it’s a good idea to consult a lactation specialist, who will be able to tell you if anything is out of the ordinary.”

If you’ve had a double mastectomy, a lactation specialist will also be able to advise you on a supplemental nursing system, a device that allows you to experience your baby latching to your breast.
 

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