SurvivorNet

Motherhood After Cancer: Actress Christina Applegate, 52, Had Her Daughter After Battling Breast Cancer— Other Women Are Likely To Have Similar Success, New Study Reveals

By Danielle Cinone,

2024-05-25

Fertility After Breast Cancer

New research has found that women ages 40 and younger, who have been diagnosed with non-metastatic breast cancer, a disease that actress Christina Applegate once battled, have a good probability of becoming pregnant and having children after fighting cancer, due to cancer advances, new data suggests.
Applegate was diagnosed with multiple sclerosis (MS) in August 2021. The disease impacts the central nervous system and can cause numbness or tingling in your limbs. Everyday activities such as taking a shower and walking up stairs prove challenging for Applegate due to her diagnosis.
The “Married with Children” star also bravely battled breast cancer after a 2008 diagnosis. She underwent a double mastectomy (removal of both breasts) to help treat the disease.
Since her breast cancer journey began, she’s advocated for women to undergo the necessary screenings for early detection and she was able to give birth to her daughter Sadie in 2011, whom she shares with her musician husband, Martyn LeNoble.

Women ages 40 and younger who have been diagnosed with non-metastatic breast cancer, a disease that actress Christina Applegate once battled, have a good probability of becoming pregnant and having live birth after fighting cancer, due to cancer advances, new data suggests. According to new findings, set to be presented next month at the 2024 American Society of Clinical Oncology (ASCO) Conference, approximately three-quarters of the 200 young women in the study were found to become pregnant after being diagnosed with breast cancer. The study, which has yet to be peer-reviewed or published fully in a journal, said that out of the women, ages 40 and under, two-thirds of them had a baby. And the data is certainly uplifting, as it offers hope to young women who strive to enter motherhood even after cancer, something Applegate was able to do after she bravely battled breast cancer after a 2008 diagnosis and underwent a double mastectomy (removal of both breasts) to help treat the disease. Applegate give birth to her daughter Sadie in 2011, whom she shares with her musician husband, Martyn LeNoble. She later opted to have her ovaries and fallopian tubes removed in 2017 as a preventative measure. For women hoping to preserve their fertility and have children after battling breast cancer, like "Married with Children" star Applegate, the new findings offer hope. https://twitter.com/EW/status/1630004591474671616 According to

Cancer Network , the study's findings, which were presented at a press briefing this month, revealed it's likely women diagnosed with stage one to three breast cancer will be able to get pregnant and have children. Speaking of the "Young Women’s Breast Cancer Study" during the briefing, study author Kimia Sorouri, MD, MPH, of the Dana-Farber Cancer Institute in Boston, said, "The current research that informs our understanding of the impact of breast cancer treatment on pregnancy and life birth rates is fairly limited. "This is the first prospective study with greater than 10 years of follow-up to report fertility outcomes in young breast cancer survivors account for attempting pregnancy." Dr. Sorouri continued, "Many young women who are diagnosed with breast cancer are interested in future fertility. However, many cancer treatments can impair an individual’s fertility and their ability to carry a pregnancy."

RELATED: Motherhood After Cancer Is Possible: Here’s What You Should Know About Fertility Preservation In the study, which didn't include women with metastatic breast cancer or those who had their uterus or ovaries removed, 1,213 patients were studied between 2006 and 2016. "Among these participants, 197 reported that they attempted pregnancy over a median follow-up of 11 years. In this group, 73% became pregnant at least once, with 90% of these patients reporting having at least one pregnancy that resulted in a live birth," Cancer Network explains. "The median time to diagnosis to the first pregnancy was 48 months, according to the data, and among the 197 women who reported pregnancies, the median age at their breast cancer diagnosis was 32 years." The press briefing also noted that "a total of 28% of patients underwent fertility preservation (via cryopreservation of embryos and/or eggs)" and "15% of patients had a known history of infertility before receiving their breast cancer diagnosis." Cancer Network notes that 76% of the women had "ER- and/or PR-positive disease," 25% had HER2-positive breast cancer and 17% had triple-negative breast cancer. As for the treatment the patients underwent, 68% had chemo, 57% received endocrine therapy, 58% underwent radiation, 38% had a lumpectomy, 22% underwent a unilateral mastectomy, and and 41% underwent a double mastectomy.

Resources On Fertility & Cancer

Meanwhile, Dr. Julie R. Gralow, Chief Medical Officer of ASCO spoke with ABC News following the briefing, saying, "This is indeed great news for young breast cancer survivors. Achieving a pregnancy after breast cancer diagnosis is both possible and safe." Dr. Gralow also said, "While we can't impact the age at diagnosis, we can make sure that all young women diagnosed with breast cancer receive information prior to beginning treatment about options to increase the chance of a future pregnancy, and also have access to those options." Dr. Sigal Klipstein, former chair of the ACOG Committee on Ethic, also told ABC News, "Ensuring that women have the resources necessary to enable them to benefit from this technology, including insurance coverage for fertility preservation, will go a long way towards ensuring access to care for those women who have yet to complete their reproductive plan. "While this study provides great hope for women with a diagnosis of breast cancer, it is important to be cognizant of the fact that not all women will have success. Expeditious counseling, availability of and access to fertility preservation options are the elements that often make the difference between having or not having the family that women desire."

Christina Applegate's Breast Cancer Journey

Christina Applegate is currently battling MS, a chronic disease of the central nervous system she was diagnosed with back in August 2021. However, prior to that, she was diagnosed with breast cancer in April 2008, when she was just 36 years old. “I went through five weeks of work without telling anyone that this was going on in my life,” she said during a CNN interview. Applegate said she had dense breasts and would need more thorough examinations for her routine mammogram screenings. “He suggested that I get an MRI,” the actress said.

WATCH: What to know about dense breasts. Dr. Connie Lehman , Chief Breast Imaging Division at Mass General Hospital, says dense breast tissue is harder to see through. “The fatty breast tissue has a gray appearance, so an X-ray beam just runs right through it. But the dense structures block the X-ray. And so that looks white. And unfortunately, cancers also block the X-ray, and so cancers also look white. When you have a white cancer hiding in white, dense breast tissue, it can be missed,” Dr. Lehman explains. Women with dense breasts are recommended a 3D mammogram, which can better see through dense breasts. When Applegate underwent an MRI screening, something was amiss. “They found some funky things going on [in one breast],” she recounted. A biopsy confirmed her diagnosis, but luckily, the cancer was caught early. Despite her prognosis, she was still very concerned with her diagnosis. She then turned her worry into determination, and she focused her efforts on beating the cancer. She underwent a lumpectomy, which is a procedure that removes the tumor and some of the surrounding tissue. For early-stage breast cancer, studies have shown that lumpectomy plus radiation is as effective a treatment in preventing breast cancer recurrence as mastectomy. SurvivorNetTV Presents: Defying All Odds Applegate then underwent six weeks of radiation, using high-energy beams aimed at the cancer cells to kill them. During treatment, she then learned she tested positive for the BRCA gene, increasing her risk of developing breast and ovarian cancer. “That sort of changed everything for me. Radiation was something temporary, and it wasn’t addressing the issue of this coming back or the chance of it coming back in my left breast. I sort of had to kind of weigh all my options at that point,” she explained. The harmful variant of BRCA1 or BRCA2 is inherited from either or both of your parents. So, each offspring of a parent who carries the mutation has a 50% chance of inheriting it. “Patients with a strong family history of breast cancer or ovarian cancer or patients who have a diagnosis of a couple of breast cancers in their lifetime will be at higher risk,” University of Maryland breast medical oncologist Dr. Kate Tkaczuk explains. WATCH: Testing for the BRCA gene mutation. RELATED: Should I have a lumpectomy or mastectomy? The actress’ doctor gave her treatment options, but she ultimately opted for a double mastectomy, which removes both breasts to reduce her cancer risk. When a woman undergoes a double mastectomy, it is a personal and emotional decision that impacts how they feel about themselves. “It just seemed like, ‘I don’t want to have to deal with this again. I don’t want to keep putting that stuff in my body. I just want to be done with this,’ and I was just going to let them go,” she explained. Just before the procedure, Applegate said she staged her “first and last nude photo shoot” so she could remember her breasts. Just before the surgery began, Applegate admitted she began to cry. “The floodgates just opened up, and I lost it…It’s also a part of you that’s gone, so you go through a grieving process and a mourning process,” she explained. WATCH: What happens during a double mastectomy. “A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue,” Dr. Elisa Port , Chief of Breast Surgery at Mount Sinai Health System, tells SurvivorNet . “The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.” Dr. Port adds most women do opt to have some reconstruction. The length of these surgeries can vary. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area, but this is a much longer procedure. Since her breast cancer journey began, she’s advocated for women to undergo the necessary screenings for early detection.

Fertility Preservation Options for Cancer Patients

Fertility struggles are also a genuine concern among cancer patients, as certain cancer treatments can cause infertility. Fortunately, in many cases, efforts can be made before beginning treatment to help preserve fertility. Many couples, at one point or another, experience infertility. The Centers for Disease Control and Prevention ( CDC ) says within the U.S., “about one in five” married women between the ages of 15 to 49 with no prior births are unable to get pregnant after trying for a year. Additionally, “one in four” of women in this group struggle to get pregnant or carry the pregnancy to term. Infertility may affect many cancer patients undergoing treatment due to cancer treatment’s impacts on the body. Various cancer treatments, including chemotherapy and radiation, can affect both men’s and women’s fertility. Before undergoing cancer treatment, patients should speak to their doctors about fertility preservation if they wish to have a family in the future. WATCH: Dr. Terri Woodard explains fertility preservation options patients have when going through cancer treatment. The American Psychological Association said in its Monitor on Psychology Magazine, "A diagnosis of infertility–the inability to get pregnant after a year or more of trying–can lead to depression, anxiety, and other psychological problems, trigger feelings of shame and failure to live up to traditional gender expectations and strain relationships, say psychologists specializing in infertility.” It's important to understand that certain types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age. “The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman previously told SurvivorNet. "If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued. Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well. Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment. If you have a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment. WATCH: How chemotherapy affects fertility. Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures. Most women preserve their fertility before cancer treatment by freezing their eggs or embryos. After you finish your cancer treatment , a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy. If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus. When freezing eggs or embryos is not an option, doctors may try these approaches:

Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment immediately and don’t have time to harvest eggs.
Ovarian suppression prevents the eggs from maturing so they cannot be damaged during treatment.
For women getting radiation to the pelvis, Ovarian transposition moves the ovaries out of the line of treatment.

In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant, and they did not have worse short-term recurrence rates than people who did not stop endocrine therapy.

Questions for Your Doctor

If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, consider asking your doctor these questions, according to the National Cancer Institute:

Could my treatment lead to infertility?
Are there other recommended cancer treatments that might not cause fertility problems?
Which fertility preservation options would you advise for me?
What fertility preservation options are available at this hospital? At a fertility clinic?
Would you recommend a fertility specialist (such as a reproductive endocrinologist) I could talk with to learn more?
What are the chances that my fertility will return after treatment?