Screening the general population of women for breast cancer with mammography is a very appealing idea. Breast cancer is the commonest cause of cancer death in women worldwide. The great majority of women who develop breast cancer have no major identifiable risk factors. There is a strong correlation between breast cancer size at diagnosis and death from the disease. And, most importantly, mammography can often detect a breast cancer years before it is large enough to be detected by a patient or health care provider.
“Fertility Studies in Young Women with Breast Cancer”
by Dr. Ellen Warner, MD, M.Sc., FRCPC, FACP
For many years there has been a gap in research focusing on breast cancer patients who are aged 40 and younger. Since these women represent just over 5% of all breast cancer cases, they have generally constituted a very small subset of the patients enrolled in clinical trials, which has made it difficult to make progress in addressing the very unique medical and psychosocial issues of this population. A recent Canadian study called RUBY (Reducing the bUrden of Breast cancer in Young women), http://www.womensresearch.ca/ruby-study, jointly funded by the Canadian Breast Cancer Foundation and Canadian Institutes of Health Research, is attempting to change this situation. Over 4 years, 1200 women aged 40 and younger newly diagnosed with breast cancer at 32 cancer centres and hospitals across Canada will be enrolling in RUBY. Almost 200 women have enrolled to date and recruitment is well on target to be completed in 2019. The overall goal of this study is to improve the cure rate and quality of life of young women with breast cancer. RUBY has several sub-studies, two of which, SPOKE and GYPSY, relate to fertility issues.
Contrary to long-held myths, we now know from well-designed studies that:
Newly diagnosed breast cancer patients don’t just care about surviving breast cancer. They also want to have normal lives once their treatment is over and retaining the ability to get pregnant is at the top of their agenda. This is more of an issue now than it was several decades ago because, since women today tend to delay childbearing, many young breast cancer patients haven’t even started let alone completed their families.
Getting pregnant after a breast cancer diagnosis, whether it ends in miscarriage or a healthy live birth, is safe even for patients with hormone sensitive (ER+) tumours.