Having a child after breast cancer: when to stop tamoxifen?

Having a child after breast cancer: when to stop tamoxifen?

Tamoxifen is a drug prescribed to reduce the risk of recurrence after breast cancer. It is an anti-estrogen that comes in tablet form. However, its side effects are numerous: hot flashes, night sweats, weight gain… And above all, this treatment is not compatible with pregnancy. Some young women therefore decide to stop it.

At 33, Ophélie starts her last box of tamoxifen. The young woman had breast cancer. For five years, she has followed her treatment to the letter. But during her last appointment, the doctor told her that she had to continue her treatment for another five years. A decision that compromises his child project.

Ophélie is waiting for her next appointment with her oncologist to find out if she can consider pregnancy.

Treatment incompatible with pregnancy

Tamoxifen is teratogenic: it can cause serious fetal malformations. Officially, the duration of this treatment is five years. But studies show the benefit of a longer prescription.

For Dr. Marc Espié, director of the center for breast diseases at Saint-Louis hospital in Paris, this extension of treatment concerns only certain patients. “For the moment, we are discussing it with patients for whom prognostic factors make us think that they have a greater risk of relapse than others. For example, when there are many diseased lymph nodes. We also take into account the patient’s tolerance to tamoxifen.

A more supervised pregnancy

After breast cancer, stopping tamoxifen should be supervised. According to Pr Michaël Grynberg, gynecologist-obstetrician at the Jean-Verdy hospital in Bondy, “the woman must discuss this with her oncologist and that she be authorized to carry out this pregnancy. This means carrying out an initial assessment of the disease, making sure that we are not in a situation at risk of recurrence… If the oncologist judges that the patient may be eligible to be able to attempt a pregnancy, we will ask her to stop tamoxifen at least two months before embarking on her maternity plan.” Two months are indeed necessary to eliminate the effects of the drug in the body.

During her pregnancy, the patient will benefit from special monitoring: regular check-ups, breast palpations, etc.

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