For a younger woman, a diagnosis of breast cancer means not only dealing with a potentially life-threatening illness, but also facing the possibility that the treatment designed to prevent the cancer from coming back will also affect her ability to become pregnant and have a child.
Most women with early stage breast cancer are cured of their disease, but treatment often includes a course of endocrine therapy lasting five years or longer, during which the woman is advised not to become pregnant, and by the end of which her fertility may be markedly reduced. Sometimes, a woman decides to stop this treatment early so that she can try to become pregnant. While there is no evidence that this increases her risk of having the cancer come back, available data is limited.
Researchers at The Breast Health Center at Women & Infants Hospital of Rhode Island, a Care New England hospital, are participating in an international trial designed to answer the question as to whether the interruption of treatment in some women with early stage breast cancer to allow them to try to become pregnant affects the long-term risk that the cancer will recur.
The trial, “Pregnancy Outcome and Safety of Interrupting Therapy for Women with Endocrine Responsive Breast Cancer” or POSITIVE, is recruiting women in the United States and around the world, according to Sonali V. Pandya, MD, the primary investigator at Women & Infants.
“We’re looking for a very specific group of women,” Dr. Pandya explains, adding that participants must be between the ages of 18 and 42, have been diagnosed with an estrogen receptor positive breast cancer for which they have been taking endocrine therapy such as the medication Tamoxifen for between 18 and 30 months, and have a desire to become pregnant.
Breast cancer is the most common serious cancer in women and approximately 15 percent of patients are diagnosed in their reproductive years.
“The biology of cancers diagnosed in young women is different from those that develop in older women,” Dr. Pandya says. “We also know that five to 10 years of endocrine therapy like Tamoxifen can substantially reduce a woman’s fertility and chance of conception, but no one has studied the effect of interrupting that treatment to allow a woman to try to become pregnant.”
With that in mind, the objectives of POSITIVE are two-fold:
1. To assess the risk of breast cancer relapse associated with the temporary interruption of endocrine therapy to allow for pregnancy.
2. To evaluate factors associated with pregnancy success after the interruption of endocrine therapy.
The research is being funded through the National Cancer Institute.
Dr. Pandya is accepting new patients. For more information, call Women & Infants’ Breast Health Center at (401) 453-7540.
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