The results of new studies of several thousand women of reproductive age. What the experts say.
Breastfeeding after breast cancer is an important issue for many young women who have experienced the disease. Doctors’ recommendations depend on several factors, including:
- The type of cancer
- The treatment received by the woman
- The physical condition of the breast.
However two new Italian clinical studies presented at the annual conference of the European Society for Clinical Oncology (ESMO 2024) show that safe breastfeeding is possible after cancer.
“Before these data were presented, physicians were very cautious, perhaps even defensive, about the possibility and safety of breastfeeding after breast cancer,” said Dr. Head of the first study Dr. FedroAlessandro Peccatori director of the Fertility and Reproduction Unit of the European Institute of Oncology, Milan.
As she explained, the big concern is the hormonal changes related to pregnancy and breastfeeding. And that’s because many breast cancers are hormone-dependent.
However, breastfeeding appears to be possible even for women with a BRCA gene mutation. These women are at increased risk of contralateral breast cancer, according to the second study’s lead researcher, Dr. Eva Blondeaux, an oncologist at the Ospedale Policlinico San Martino in Genoa.
The two studies, despite their differences, demonstrated that breast cancer does not have to exclude the possibility of breastfeeding.
The first study
The first study, called POSITIVE, involved 518 women from 116 centers in 20 countries around the world. They had hormone receptor-positive breast cancer. These women had temporarily stopped adjuvant hormone therapy to have children.
317 of them successfully completed at least one pregnancy. 62% of them breastfed their babies.
In the two years since the babies were born, breastfeeding did not appear to have an impact on the women’s health. In particular, there were no significant differences in the rates of recurrence or new breast cancer between those who breastfed and those who did not. It was 3.6% versus 3.1%, respectively.
The second study
The second study involved 4,732 women from 78 international research centers. They were diagnosed with breast cancer at a young age. In addition, they were carriers of a BRCA gene mutation.
Of the 474 women who had a child, 110 breastfed their infants (23.2%). Breastfeeding did not show any significant differences between groups in terms of local recurrence or development of contralateral breast cancer.
“These are the first unequivocally encouraging results on the safety of breastfeeding after breast cancer in young women with BRCA mutations,” said Dr. Blondeaux.
This study had a relatively long follow-up period (up to 7 years), but was retrospective. Therefore, new prospective studies are needed to confirm the data.
What the experts say
The topic of breastfeeding after breast cancer has only recently begun to attract the attention of researchers, emphasize the doctors of the EKPA Therapeutic Clinic of Alexandra Hospital Dr. Maria Kaparelou (pathologist-oncologist), Theodora Psaltopoulou (pathologist, professor of Therapy, Epidemiology and Preventive Medicine) and Thanos Dimopoulos (former rector of EKPA, professor of Therapy, Oncology and Hematology, director of the Therapeutic Clinic).
Survival rates have now become so high that women have 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. However, not all women experience motherhood in the same way and some choose not to breastfeed. “However, it is important not to deny the possibility of breastfeeding to women who want it, simply because of a lack of data,” the experts emphasize.
And they conclude: “The results of the two studies presented at ESMO are particularly useful in this regard. And they provide the basis for more careful counseling, which takes into account the needs of the woman and the child as well as the safety of the mother in terms of oncological data.”