Get regular breast exams and check with your doctor if you see anything suspicious, and learn about the treatment options available for breast cancer during pregnancy.
Gestational breast cancer, diagnosed during pregnancy or in the first year postpartum, affects about 1 in 3,000 pregnant women aged 32 to 38 years. The risk of breast cancer increases with age. As the number of older pregnant women increases, the number of breast cancer patients during pregnancy may also increase. Learn how to detect it early and what treatment options are available during pregnancy and postpartum.
Breast Cancer Awareness Month
Faith's second chemotherapy session at Singapore's KK Women's and Children's Hospital.
October marks Breast Cancer Awareness Month, which aims to raise awareness of this cause. This year's theme focuses on finding support so no one has to fight cancer alone. Instead, get your loved ones regular mammograms and practice breast self-examination for early detection.
Detection of breast cancer during pregnancy
Check for any lumps in the breasts, nipple discharge, persistent breast pain, itching or redness in the nipples. Other signs of breast cancer may include redness or darkening, swelling or warmth in the breast. Because these changes are similar to breast changes during pregnancy, diagnosis is often made at a later, more advanced stage than in nonpregnant patients.
See your doctor if the lump remains after a week or returns to its original position after being treated for fallopian tube blockage. If it continues to grow, doesn't move, is hard or firm, or causes dimpling of the skin, or you notice any other changes in your breast, check with your doctor. More than 80% of breast tumors during pregnancy are benign.
In general, women with a family history of breast cancer should be extra vigilant and report the problem to their obstetrician-gynecologist before trying to get pregnant. Published data vary widely regarding outcomes for breast cancer patients during pregnancy. Some show similar outcomes to nonpregnant patients, while others show a worse prognosis.
Treatment of breast cancer during pregnancy
If you are pregnant and have any suspicious symptoms or lumps, you will be diagnosed via ultrasound. This will also monitor your baby's development during treatment.
During pregnancy
Make sure your medical team treats breast cancer risk factors to ensure the health of the mother and fetus. Therefore, your team may include radiologists, oncologists, breast surgeons, breast care nurses, and obstetricians. If you have any suspicious symptoms, you will be diagnosed through a breast ultrasound without the use of ionizing radiation. This diagnostic tool is highly sensitive and specific, and can look for changes in the size and consistency of your axillary lymph nodes.
The first treatment for breast cancer is usually surgery to remove the tumor. This is safe throughout all three months of pregnancy. You may consider having temporary implants or tissue expanders placed during your pregnancy to reconstruct your breasts after giving birth. After the first three months, chemotherapy is a safe option. The risk of fetal malformations is similar to that in cases not exposed to chemotherapy during pregnancy. However, radiation, anti-HER2, or endocrine therapy with tamoxifen should not be performed during pregnancy. Take these after your baby is born.
Postpartum treatment
After giving birth, you can try other treatments if necessary. These include radiation therapy, which is often used after breast-conserving surgery to reduce the risk of the cancer coming back. Because high doses of radiation can harm the baby, causing miscarriage, birth defects, or a higher risk of childhood cancer, start doing this after birth. However, waiting too long to start radiation therapy can increase the risk of the cancer coming back.
Another option is hormone therapy to treat advanced breast cancer in women with hormone receptor-positive breast cancer. These drugs include tamoxifen, anastrozole, letrozole, and exemestane. If you have cancer of the HER2 type, a growth-promoting protein on the outside of breast cells, you may need to try targeted therapy and take trastuzumab or pertuzumab.
Take care of your baby
Intrauterine monitoring
During cancer treatment, your fetus will also be closely monitored. Risks from intrauterine chemotherapy include intrauterine growth restriction, low birth weight, premature birth and temporary leukopenia - where she has fewer disease-fighting white blood cells. You will need growth scans and detailed anatomical scans if you are taking the medication in the first trimester. If your baby is growing more slowly than expected, you may have to have more frequent growth scans, which may include Doppler tests and prenatal tests to know the health of the fetus.
Effects of intrauterine chemotherapy on children
Although there have been no cases of cancer spreading from the breast to the fetus, there have been isolated reports of it traveling to the placenta. After birth, the placenta must be sent for pathological evaluation. Children do not experience side effects after being exposed to chemotherapy in the womb. A study of 84 children receiving in utero chemotherapy to treat cancers affecting the blood, bone marrow and lymph nodes found no abnormalities or cancers.
Transport
Try to deliver on time or naturally if possible. You may consider induction or a cesarean section if you are due to give birth when your breast cancer is discovered, so you can have hormone therapy, targeted therapy and radiotherapy if necessary. You may stop chemotherapy treatment before 36 weeks so you have enough white blood cells to fight disease during labor. These blood cells fight bacterial infections around the membranes surrounding the fetus, amniotic fluid, and peritoneal infections. If absent, these can lead to increased morbidity or mortality during cesarean section.
Breastfeeding after breast cancer
Depending on your treatment options, you may or may not be able to breastfeed your baby. Rest assured that feeding your newborn formula or getting milk from a milk bank are great options to help your baby develop. You can breastfeed your baby if you have had a lumpectomy, which means the tumor and the edge of the healthy breast lump have been removed. Women who have had a mastectomy can breastfeed from the other breast. If you have undergone radiation therapy, some lobules of the breast may be damaged, causing them to be unable to produce milk. Additionally, breast milk may look thicker and darker. Although there is no evidence that feeding your baby this type of milk is dangerous, you may choose not to feed it to your baby.
Motherswork recommendation: Infant formula (up to $59)
Pregnancy after breast cancer
Use safe birth control methods, such as an intrauterine device or barrier method, instead of hormone therapy. Wait at least two years from when the disease is in remission before trying to conceive again. To conceive in the future, freeze your eggs or embryos before undergoing chemotherapy.
Breast cancer support group
Gather a support system around you, including your medical team, friends, family, and spouse.
Receiving such news can be extremely disturbing and terrifying. Not only do you have to worry about your own health, but you also have to worry about the little fetus growing inside you. Build a support system around you, including your healthcare team, partner, family, and friends. Make sure your doctor provides clear information about the disease, treatment plan, and risks while caring for your growing baby.