OHIO — Katie Robb Sewall has the life she always wanted. 

She’s a mother, and her 18-month-old twins Millie and Cormac keep her busy.

What You Need To Know

  • For young women with breast cancer, infertility can be a major concern amid the difficult diagnosis.

  • A new study is offering hope that pregnancy can happen safely even after cancer treatment.

  • The "Positive Trial" focused on patients with hormone receptor-positive breast cancer who interrupted hormonal therapy while trying to get pregnant. 

But in 2014, she feared she may not be able to get pregnant after she was diagnosed with breast cancer at age 27.

“Shock and just total terror," she said.

After a bilateral mastectomy, she learned the cancer had spread to her lymph nodes and was stage 3.

“Initially you go to, 'oh I don’t want to die,'" she said. "'Like, is this going to kill me?' And then, 'if it doesn’t kill me, like I really hope that I can have kids.'"

Robb Sewall and her husband Craig then connected with Dr. Halle Moore at the Cleveland Clinic to learn about her cancer and fertility treatment options.

She was told she’d need chemotherapy, radiation, and five to ten years of hormonal therapy.

Before she started chemo, she gave IVF a try, but it didn’t work.

A combination of egg retrieval and ovary suppression medication was her best bet to keep the prospect of pregnancy open for the future.

“I didn’t know once I was done with treatment if I would be able to have my own kids," Robb Sewall said.

After five years of hormonal therapy, she paused treatment and underwent IVF again.

She describes finding out she was pregnant with twins as a dream come true.

“Begged and begged and prayed and prayed for one, and then we got two," she said. "And it just felt so exciting."

A recently published study known as the “Positive Trial” shows promising results for women like Robb Sewall.

It focused on patients with hormone receptor-positive breast cancer who interrupted hormonal therapy while trying to get pregnant. 

The trial found the group who went without therapy for about two years did not experience increased risk of short-term recurrence compared to those who never stopped treatment.

Dr. Moore was involved in the research.

“For people like Katie who have made a decision to interrupt treatment in the absence of strong data supporting the safety, I think it’s really important to know that this is not likely to change the outcome," Moore said. “There wasn’t any evidence that pregnancy hormones somehow triggered recurrence.”

Robb Sewall was put back on hormonal therapy after giving birth. She’ll need the treatment for another five years.

She hopes other women in a similar situation realize there can be life after cancer.

“Very grateful for my life and for my kids," Robb Sewall said.

Spectrum News spoke with Moore about why struggles with fertility are common among young women with breast cancer. She said it's a complex issue with several factors. For one, chemotherapy can affect the ovaries and cause premature menopause. But that’s not the only reason.

The length of treatment can also pose a problem.

“Delaying pregnancy to complete the cancer treatment can also affect fertility just by being that much older when you have the opportunity to attempt a pregnancy," Moore said.

Dr. Moore pointed out women with successful pregnancies during the Positive Trial had no increased risk of birth defects.

Right now, trial patients are at three years of follow up. Moore said researchers will continue to follow results for years to come in order to have long-term data about the safety of this approach.