Increasingly, young women are developing breast cancer before they’ve had children or completed their families. In the past, they have been told by doctors they likely can’t or shouldn’t plan to become pregnant after their treatment.
Cedars-Sinai researcher Dr. Philomena McAndrew wants to change that prospect. We sat down with her to learn more about her research and what she’s hoping to accomplish.
What are you studying?
Dr. McAndrew: This international study, the POSITIVE trial, will look at women who wish to take a break from cancer treatment to try to become pregnant. The purpose of the study is to determine whether having a child after temporarily stopping endocrine treatment, also known as anti-hormonal or anti-estrogen therapy, is feasible and safe in patients with a hormone receptor-positive, early breast cancer. “Hormone receptor-positive” means the cancer cells grow in response to the hormones estrogen or progesterone.
The patients in the study have already received prior treatment for the cancer and are now in a maintenance period of treatment.
Usually after a diagnosis of breast cancer, it is recommended that a patient receive anti-estrogen treatment to try to reduce both the risk of developing a new breast cancer in the future as well as the spread of the diagnosed breast cancer to the rest of the body. Therefore, these patients are usually on a 5-year plan of anti-estrogen therapy and have completed 18-30 months of it. The break will last approximately 2 years to give the patient time to become pregnant either naturally or through fertility treatment. They will then go back on their treatment to complete the planned course of therapy.
Why are you studying this?
Dr. McAndrew: Many women and their physicians are worried that trying to become pregnant after treatment will increase the chance of the cancer spreading in the future.
There is common concern that increased hormone levels related to pregnancy might increase the risk of the cancer spreading. We don’t know if taking a break during the anti-hormonal maintenance therapy will have any impact on the risk of the cancer returning, even if they go back to complete the planned therapy.
Data shows these patients don’t have a higher chance of their cancer spreading in comparison to women who have never become pregnant after their breast cancer. Even though data doesn’t suggest increased risk, this has never been studied.
What are you hoping to achieve with this study?
Dr. McAndrew: We hope to finally show that young women who have developed breast cancer don’t have to be denied the hope of having a family or more children after their diagnosis. Numerous women have had pregnancies after they have had a hormone receptor-positive breast cancer.
To learn more about this trial as well as other current cancer clinical trials at Cedars-Sinai, visit the Samuel Oschin Comprehensive Cancer Institute’s clinical research page.