Although receiving a breast cancer diagnosis during pregnancy is relatively rare, occurring in approximately 1 in 3,000 pregnancies, it’s crucial to take action promptly. Managing the mother’s health and ensuring the safety of the unborn baby requires a delicate balance and specialized care.
Pregnancy hormones such as estrogen can potentially fuel the growth of certain types of breast cancer, underscoring the importance of early detection and intervention. Research investigating the impact of hormones related to pregnancy indicates that heightened levels of estrogen, progesterone, and insulin-like growth factor 1 (IGF-1) can contribute to the promotion of breast cancer cell proliferation.
Continue reading to learn more about breast cancer and expectant mothers, including diagnosis details and treatment options for breast cancer during pregnancy.
Diagnosis Challenges
Natural changes in breast tissue during pregnancy make it challenging to diagnose breast cancer during pregnancy. Breasts typically become denser and larger, making lumps more difficult to detect. Healthcare providers often rely on breast ultrasound as the initial diagnostic tool to minimize radiation exposure. Mammograms can also be performed with abdominal shielding to protect the fetus.
Diagnostic Procedures During Pregnancy
Diagnosing breast cancer during pregnancy presents unique challenges due to the need to minimize potential risks to the developing fetus. However, several diagnostic techniques are considered safe for expectant mothers:
Clinical breast exam: A healthcare professional physically examines the breasts
Breast ultrasound: This imaging technique using high-frequency sound waves creates pictures of the breast, posing no radiation risk to the fetus
Mammography: According to The American College of Radiology, while mammograms involve low doses of radiation, they may be recommended after weighing the risks and benefits
Risk Factors and Symptoms
In addition to the risk factors all women face for developing breast cancer, risk factors during pregnancy can increase due to:
Family history of breast cancer
Family history of late menopause
First menstruation (menarche) before age 12
First pregnancy after age 30
Previous pregnancies not followed by breastfeeding
Hormonal changes during pregnancy cause the breasts to undergo transformations. They may become larger, lumpy, and tender, making it more challenging for you or your doctor to detect a cancerous lump until it becomes significantly large. So, it’s crucial to stay vigilant and aware of these symptoms.
A lump or thickening in the breast or underarm
Changes in the size or shape of the breast
Discharge from the nipple (other than breast milk) or blood from the nipple
Dimpling, puckering, or swelling
Scaly or red skin
Nipple turned inward
Treatment Options for Breast Cancer During Pregnancy
Treatment of breast cancer during pregnancy depends on the stage of cancer, the trimester of pregnancy, and the health of the mother and baby. The main goal is to treat the cancer as effectively as possible while minimizing risks to the fetus.
Surgery
Surgery is often considered the safest cancer treatment during pregnancy. It can include either a lumpectomy (removal of the tumor and some surrounding tissue) or a mastectomy (removal of the entire breast). These procedures are generally safe during all trimesters.
Chemotherapy
Chemotherapy may be an option during the second and third trimesters when the risk to the developing fetus is lower. Drugs commonly used include doxorubicin and cyclophosphamide, which are relatively safe after the first trimester.
Radiation
Doctors typically avoid radiation therapy during pregnancy due to the risks it poses to the developing fetus, including potential congenital disabilities and growth restrictions. It is usually postponed until after delivery.
Targeted therapy
Oncologists may recommend some targeted therapies or molecular targeted therapies during pregnancy. These therapies utilize drugs to focus on specific molecules found in cancer cells to halt their growth and spread. These therapies can destroy cancer cells or significantly slow their progression while minimizing harm to normal cells. Additionally, targeted therapies are beneficial for individuals with BRCA gene mutations who develop breast cancer. However, doctors use them only if necessary because their safety profile is less well-established.
Monitoring Fetal Health
The health of the fetus is monitored closely throughout cancer treatment. The monitoring process typically includes regular ultrasounds to check fetal growth and development and non-stress tests to monitor fetal heart rate.
Multidisciplinary Support for Expectant Mothers
Managing breast cancer during pregnancy requires a collaborative approach involving medical professionals from various disciplines, including:
Oncologists
Obstetricians
Neonatologists
Genetic counselors
Psychologists and support groups
A multidisciplinary team works together to develop a personalized treatment plan that prioritizes the well-being of the mother and the baby while providing emotional support throughout the experience.
Count On Us for Information, Resources, and Support
Breast cancer during pregnancy poses unique challenges. With the appropriate care, most women can go on to deliver healthy babies and effectively manage their cancer treatment. Early detection and a tailored treatment plan are crucial for the best outcomes for both mother and child.
Whether you’re newly diagnosed with breast cancer, are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms, testing, treatment options, surgery, etc., and podcasts that feature professionals, advocates, and caregivers who share valuable information.
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Note: This article is designed to provide general information and is not meant to replace professional medical advice. Always discuss your options with your healthcare provider.
Learn More:
On the Podcast: Breast Cancer Conversations
Hope: with Julia Maués and Christine Hodgdon
SurvivingBreastCancer.org Resources & Support:
