THE breastfeeding after breast cancer is an important issue for many women who have experienced this disease and are concerned about breastfeeding their children in the future.

Medical advice and conclusions depend on several factors, such as the type of cancer, the treatment the woman has received, and the physical condition of the breast.

The Doctors of the Therapeutic Clinic (Alexandra Hospital) of the Faculty of Medicine of EKPA Dr. Maria Kaparelou (Pathologist – Oncologist), Theodora Psaltopoulou (Pathologist, Professor of Therapeutics-Epidemiology-Preventive Medicine) and Thanos Dimopoulos (former Rector EKPA, Professor of Therapeutics-Oncology-Hematology, Director of Therapeutic Clinic) report that breastfeeding is possible even after breast canceraccording to findings from two international clinical studies led by Italian researchers, presented at the 2024 Annual Meeting of the European Society for Medical Oncology (ESMO).

“Prior to the presentation of these data, physicians were very cautious, perhaps even defensive, about the possibility and safety of breastfeeding after breast cancer,” said Fedro Alessandro Peccatori, director of the Infertility Unit at the European Institute of Oncology in Milan, Italy and principal investigator of the POSITIVE study.

Doctors are concerned about the potential risks of breastfeeding after breast cancer because of the change in hormones that occurs during pregnancy and lactation, because many breast cancers are hormone-dependent.

“These estimates also apply to women who carry a BRCA gene mutation who have an increased risk of cancer in the contralateral breast,” said Eva Blondeaux, MD, an oncologist at Ospedale Policlinico San Martino in Genoa, Italy, and principal investigator of the second study presented.

What 2 new studies show

The two studies, despite their differences, showed that breast cancer should not rule out the possibility of breastfeeding.

In the study POSITIVE involved 518 women (from 116 institutions in 20 countries on four continents) with hormone receptor-positive breast cancer who had temporarily discontinued adjuvant hormone therapy to achieve pregnancy.

In total, 317 women successfully completed at least one pregnancy and 62% breastfed. Analyzes revealed no significant differences in 24-month recurrence rates or new breast cancer rates between women who breastfed and those who did not breastfeed (3.6% vs. 3.1%).

At second study included 4,732 women from 78 international centers who were diagnosed with breast cancer at a young age and were carriers of a BRCA gene mutation. Of the 474 women who gave birth, 110 (23.2%) breastfed. Breastfeeding showed no significant differences between the groups in terms of local recurrences or the development of contralateral breast cancer.

“That’s it the first undeniably encouraging results on the safety of breastfeeding after breast cancer in young women with BRCA mutations,” Blondeaux said, noting that the study had a relatively long follow-up period of 7 years but was retrospective. Therefore, new prospective studies are necessary to confirm the data.

The topic of breastfeeding after breast cancer has only recently begun to attract the attention of researchers, as survival rates have become so high that they offer women the freedom to choose whether or not to have children.

In recent years, numerous studies have shown that pregnancy is possible and safe after breast cancer, even with the use of assisted reproduction.

Breastfeeding is an important part of pregnancy and motherhood, but not all women experience motherhood the same way and some choose not to breastfeed. However, it is important not to deny women the opportunity to breastfeed simply because of a lack of evidence.

The results of the two studies presented at ESMO are particularly useful in this regard and provide the basis for more careful counselling, taking into account the needs of the woman and the child as well as the safety of the mother in terms of oncological data.