Women become pregnant after stopping hormone treatment for breast cancer


While millions of Brazilians watched the extension of the game between Brazil and Croatia for the Cup, on the last day 9, oncologists from all over the world were waiting for the results of a match in the scientific area. On one side of the study, women undergoing treatment for breast cancer who wanted to become pregnant. On the other, the indication of hormone therapy for five or ten years, making motherhood difficult.

And it was time for the penalty kicks, when the Brazilian team fell to the Croatians, that the outcome of the research echoed in the auditorium of the San Antonio Breast Cancer Symposium, in Texas: patients who pause hormone therapy to try to get pregnant have rates of breast cancer recurrence breastfeeding similar to those who do not interrupt, and many manage to become mothers.

The study was already pointed out behind the scenes as one of the highlights of the event, the largest in the world on breast cancer, and made oncologists happy — despite doubts that still need to be investigated.

“The patient will be able to make an earlier decision to interrupt the treatment to try to get pregnant”, celebrates Gilberto Luiz da Silva Amorim, doctor at Oncologia D’Or and one of the Brazilian professionals who switched from the soccer game to accompany the presentation of the research. “Until today I haven’t seen the penalties”, he jokes.

The research began in December 2014 and involved 518 volunteers aged 18 to 42 years old, assisted in 116 centers in 20 countries, including Canada, Spain, United States, France, Italy and Japan. All were diagnosed with hormone receptor positive breast cancer, a type of tumor that is stimulated by estrogen or progesterone, and wanted to get pregnant.

They underwent chemotherapy treatment, for example, and between 18 and 30 months underwent therapy with hormone blockers. Afterwards, they discontinued the medication for approximately two years, during which time they had three months of detoxification followed by the period in which they could try to conceive naturally or through artificial insemination.

At 41 months of follow-up, 44 participants experienced breast cancer recurrence. At three years, the recurrence rate was 8.9%, similar to the 9.2% found in another study on hormone therapy with premenopausal women.

Of the 497 volunteers who kept trying to get pregnant, 368 (74%) had at least one pregnancy and 317 (63.8%) gave birth to at least one baby. In all, 365 children were born.

After the predetermined period for attempts and pregnancies, the women were instructed to resume hormone therapy and will continue to be followed up to verify the recurrence rate. The study is expected to be completed in December 2028.

“The Positive study provides important data to support young women with hormone receptor-positive breast cancer who are interested in becoming pregnant”, comments researcher Ann Partridge, from the Dana-Farber Cancer Institute, who led the study in North America.

For Amorim, the results make it possible to break a barrier. Until now, he has always guided patients to wait for five or ten years of hormone treatment before trying to get pregnant. Now, he sees the possibility of talking to patients about anticipating the interruption.

“Historically, we have had difficulty telling these patients that they can get pregnant because they are undergoing hormone treatment and because there is a concern about the impact of increased hormones with pregnancy. women.”

But there are caveats. In 93.4% of the cases, the volunteers had stage 1 or 2 cancer, and it is necessary to follow up the patients for a longer period of time to check whether there will be a greater recurrence of the cancer in the future.

Furthermore, Amorim points out that women over 35 years of age are already beginning to experience reduced fertility, and procedures such as chemotherapy and hormone therapy can intensify this process. Therefore, women with cancer who intend to become pregnant should consider the possibility of freezing eggs.

“The patient is faced with a difficult diagnosis and doesn’t even have time to decide. Sometimes, even the family says: ‘Let it go. The priority is for you to get well. Forget about motherhood.’ These women do not forget. It is a serious disease, but in some cases it is possible to reconcile interests”, says the oncologist.

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