Ovulation Treatments and Breast Tumors

When women are pregnant, or breast feeding, or taking birth control pills, they are not ovulating, and they are therefore at reduced risk of ovarian cancer. This is further true if you have breastfed more than one baby, and if you have had children when you were younger, rather than older. When women are given ovulation inducing medications they may be slightly increasing their risk. Patients worried about starting infertility treatments often express this concern to me. Studies have varied in their interpretation of breast and ovarian cancer risk for the infertility patient. Most women don't ovulate too many 'extra' times with just a few short months of infertility ovulation treatment, so ovarian cancer not regarded as an actual consequence of fertility enhancing ovulation treatment, and that is what we routinely tell our patients. In fact if a woman has an ovarian cyst, we don't normally stop infertility treatments. But as we still see breast cancer as the most common cancer in women we are wondering more about breast cancer risk from infertility treatments. But up until now we have paid less attention to what the breast tissue response of ovulation treatments have been. One of the most common kinds of breast lump is a fibroadenoma. Not only are fibroadenomas of the breast not thought to be cancerous, but they are not thought to be able to turn cancerous. A single case has now been reported in Fertility and Sterility of a fibroadenoma breast lump turning into a cancerous tumor during fertility treatment. Fertility treatments increase estrogen blood levels and this is theorized to be the way a noncancerous breast lump could turn cancerous when stimulated with enough estrogen. Currently there are no specific recommendations for fertility patients who have non-cancerous breast lumps to be treated any differently than your gyno would normally. Maybe you need to stop smoking, pay attention to your diet, limit long term hormone treatments after menopause, increase your exercise or limit your alcohol intake; but maybe you should first get any breast lumps treated appropriately. But this case calls attention to an important development in breast care that we will have to follow. Your gyno can calculate your risk of breast cancer by formulas available. Options for following your breast cancer risk would include extra clinical breast exams with your gyno or the Halo Breast Pap Test. Although we do not uniformly encourage women to do self breast exams, it may be that an infertility patient undergoing ovulation treatments should be more attentive to them.

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