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How do you counsel young women who want to become pregnant after breast radiotherapy?

A 40 year old patient receiving post-op RT for breast cancer asked me if there is any risk for her becoming pregnant after completing RT. Eric Hall's radiobiology text indicates a very low risk of deleterious mutations but suggests a "prudent and conservative approach" of recommending delay of conception for at least 6 months to a year after a "significant" radiation exposure. Any update on recommendations for my patient, where the gonadal exposure is very low?
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Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

It also depends on whether she is on tamoxifen or not and whether she has had chemotherapy. She has to be off tamoxifen if desires to have a pregnancy. We also counsel them that milk output is usually less in the treated breast and that it is not contraindiacted to breast feed.

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