By ELLYN SANTIAGO
Dr. Lipsyc-Sharf was the Keynote Speaker for the 17th Annual Terri Brodeur Breast Cancer Foundation Board Meeting. She shared her answers to a couple of questions related to the latest in breast cancer research and study.
TBBCF: As one of your primary focuses is working with young women breast cancer patients, I noticed that you recently tweeted about the news a recent study found that “temporary interruption of #EndocrineTherapy to attempt #pregnancy is safe in #BreastCancer patients.”
You called it “wonderful news.” Indeed it is. And while it’s not just young women who are looking to become pregnant or carry a pregnancy while in breast cancer treatment, I suspect this is really welcome news for those younger patients. Can you tell us a little more?
Lipsyc-Sharf: “Yes, this is indeed wonderful news! I have a lot to say about this so please edit/cut out as needed! The POSITIVE study is a really important step forward for young patients with estrogen receptor positive breast cancer. Over 10,000 young women (40 years of age or younger) are diagnosed with breast cancer annually, and it is estimated that half of these women have concerns about fertility and/or future pregnancy after a diagnosis of breast cancer. There has been some concern in the scientific community as to whether pregnancy after breast cancer is safe for patients with estrogen receptor positive breast cancer. Additionally, many women with estrogen receptor positive breast cancer are treated with endocrine therapy (treatments that lower estrogen or block estrogen) for five years or even longer, and for many young women diagnosed with breast cancer, it is not feasible or desirable to defer pregnancy for five or more years. So, the POSITIVE trial studied the safety of pregnancy after diagnosis of estrogen receptor positive breast cancer in women that took a break from their endocrine therapy to pursue pregnancy. After the pregnancy was over, it was recommended that the women resume their endocrine therapy for the complete course of treatment. The wonderful news about the POSITIVE trial was that, in these women who had estrogen receptor positive breast cancer, taking a break from endocrine therapy to pursue pregnancy did not increase breast cancer risks compared to a control cohort of patients that did not take a break from endocrine therapy to pursue pregnancy. While the women in this trial will certainly be followed for years to come, this initial data shows the safety of taking a break from endocrine therapy to pursue pregnancy. This is life-changing for the thousands of young women each year that are diagnosed with breast cancer. Because most young women with early-stage breast cancer will survive their breast cancers, improving quality of life is so incredibly important. We know that impaired fertility and pregnancy after breast cancer affects many patients’ quality of life; it is so meaningful for many young women with breast cancer to maintain their ability to have children and not compromise their breast cancer outcomes.”
TBBCF: What are your thoughts on the recent draft guidelines from The US Preventive Services Task Force stating that women should be screened for breast cancer every other year starting at age 40 instead of 50?
Lipsyc-Sharf: “I personally think this is a very important move back in the right direction from the USPSTF. Previously, there was a recommendation for starting mammograms at age 40 that then was increased to age 50 in 2009 due to concern regarding the implications of false-positive mammograms in women ages 40-50. But, for the over 20 million women that are between ages 40-50 in the United States, the incidence of breast cancer is increasing. I am glad to see the USPSTF taking this step in the right direction, particularly because USPSTF guidelines are so important in determining how accessible these screening studies are to many patients in the United States.”