Since triple-negative breast cancer is not fueled by hormones, is it safe for a triple-negative survivor to become pregnant after treatment or could i

Pregnancy after breast cancer is always one of the most difficult topics to discuss with patients. First and foremost, the treatment of the cancer with surgery, chemotherapy, and radiation needs to be the first and foremost important aspect in this discussion, as caring for the woman who has the breast cancer and treating her appropriately to allow her to have the greatest chance for long term disease-free survival is of the utmost importance. Once a patient has completed her treatment, it is recommended in my practice, as well as those of the medical oncologists I work with, that the patient wait for at least a 2-3 year period after treatment of their cancer prior to initiating attempts to become pregnant. If I have patients in their mid-30s who are about to undergo chemotherapy, I will discuss with them prior to their treatment what options would be available to them to help to maintain fertility: to potentially perform egg retrieval and fertilization prior to their treatment if pregnancy is of utmost importance to them after completion of their chemotherapy. In women who are estrogen-receptor positive, the concern about pregnancy immediately after treatment is from the overabundance of hormones such as estrogen and progesterone that are produced during pregnancy that could potentially fuel any cancer cells that may have been left over from the initial cancer. In my patients who are estrogen-receptor positive in a premenopausal setting I recommend that they complete their 5 years of tamoxifen, but there are many medical oncologists who would, after 2 years, allow the patient to go off their tamoxifen to initiate pregnancy. There are many factors beside just estrogen-receptor positivity that would need to be taken into account when considering pregnancy after breast cancer. Each patient needs to be counseled individually and when all of the risks, benefits, and potential rewards of the pregnancy are discussed, that couple can then make an educated decision about how and when to proceed with pregnancy.