Pregnancy And Breast Cancer What You Need To Know

Breast cancer during pregnancy, also known as pregnancy-associated breast cancer (PABC), is relatively rare, occurring in approximately 1 in 3,000 pregnancies. However, as more women delay childbearing until their 30s or 40s, the incidence of pregnancy and breast cancer has increased. Breast cancer remains the most common cancer diagnosed in women, and its risk rises with age. While pregnancy itself does not directly cause breast cancer, the overlap of advanced maternal age and cancer risk is a contributing factor. Importantly, the condition can be more challenging to diagnose during pregnancy due to hormonal changes that mimic typical pregnancy-related breast symptoms, such as breast enlargement and tenderness.

The symptoms of pregnancy and breast cancer are similar to those in non-pregnant women. However, due to the breast changes that occur during pregnancy, such as swelling and tenderness, symptoms may be mistaken as pregnancy-related. Here are the key signs to watch out for:
A new lump or mass: Persistent lumps, especially those that feel firm and immovable, are concerning and should be examined.
Changes in breast shape or size: While changes are expected during pregnancy, uneven or sudden alterations in one breast could signal an issue.
Nipple discharge: Clear, bloody, or unusual discharge, especially if it occurs from only one nipple, is worth investigating.
Dimpling or puckering of the skin: If the skin takes on an orange-peel appearance or dimples inwards, this could be a sign of a tumour.
Swollen lymph nodes in the armpit: Lumps or swelling in the armpit can indicate the spread of cancer to the lymph nodes.
It’s essential to pay attention to persistent or unusual breast changes and report them to your healthcare provider for further evaluation.

Diagnosing pregnancy and breast cancer requires careful consideration to protect both the mother and the baby. Several diagnostic methods are safe during pregnancy and can help identify the disease:
Clinical Breast Exam: A healthcare professional will manually check for lumps, changes in breast tissue, or unusual findings during a physical examination.
Ultrasound: Ultrasound imaging is safe for both the mother and the fetus. It helps differentiate between fluid-filled cysts and solid masses that may indicate cancer.
Mammogram with shielding: Although mammograms use low doses of radiation, they can still be performed during pregnancy with appropriate shielding to protect the fetus. A mammogram can provide detailed imaging of suspicious areas in the breast.
Biopsy: If imaging suggests a suspicious lump, a biopsy will be performed to confirm the diagnosis. A small amount of tissue from the lump is extracted and analysed to check for cancer cells. This procedure is safe during pregnancy.
Each case is unique, and diagnostic tools are selected based on individual factors such as the stage of pregnancy and the appearance of the tumour.

Yes, it is possible to treat pregnancy and breast cancer safely, but the approach varies depending on several factors, including the stage of pregnancy and the cancer’s progression. The goal is to protect the mother’s health while minimizing any risk to the baby. Here’s an overview of treatment options:
Surgery: Surgery is considered the safest treatment for breast cancer during pregnancy. A lumpectomy (removing the tumour) or mastectomy (removing the entire breast) can be performed during any trimester. Lymph nodes may also be removed if necessary.
Chemotherapy: Chemotherapy can be used during the second and third trimesters, as the baby’s organs have already formed by this stage. However, chemotherapy is generally avoided during the first trimester due to the risk of birth defects and miscarriage. Certain chemotherapy drugs are considered safe in later pregnancy, but your oncologist will carefully tailor the treatment plan to your situation.
Radiation Therapy: Radiation is typically avoided during pregnancy because it can harm the fetus, especially during the first trimester. If radiation is necessary, it’s usually delayed until after childbirth.
Hormonal and Targeted Therapies: These treatments are generally postponed until after delivery, as they can interfere with fetal development.
It’s important to work closely with an experienced healthcare team, including an oncologist, obstetrician, and perinatologist, to create a treatment plan that balances the health of both the mother and the baby.

Chemotherapy can pose risks to the fetus, especially during the first trimester when the baby’s organs are developing. For this reason, chemotherapy is typically avoided in the first 12 weeks of pregnancy to prevent the possibility of birth defects or miscarriage. However, after the first trimester, chemotherapy can often be administered with minimal risk to the baby.
During the second and third trimesters, many women receive chemotherapy for pregnancy and breast cancer without significant harm to the fetus. While there is no evidence that chemotherapy directly causes birth defects in later pregnancy, it can sometimes lead to complications such as low birth weight or preterm labour. Regular monitoring of the baby’s development and growth is essential.
Each case is unique, and your oncologist will select chemotherapy drugs that are considered safe during pregnancy. Commonly used drugs for pregnancy and breast cancer include anthracyclines (such as doxorubicin), but other medications may be considered depending on your cancer type and stage.

In some cases, women with pregnancy and breast cancer may need to deliver their baby early, especially if more aggressive cancer treatments are required. Doctors may recommend preterm delivery to allow for intensive therapies, such as radiation or certain chemotherapies, that cannot be safely administered during pregnancy.
However, many women with breast cancer can carry their pregnancy to term, particularly if the cancer is diagnosed and treated early. If an early delivery is necessary, healthcare providers will closely monitor the baby’s development, and efforts will be made to minimize complications. Premature babies may face challenges such as low birth weight or breathing difficulties, but advances in neonatal care have improved outcomes for preterm infants.

Whether or not you can breastfeed while being treated for pregnancy and breast cancer depends on the type of treatment you receive. Some cancer treatments, such as chemotherapy, radiation, and certain hormonal therapies, can be harmful to the baby and can pass through breast milk. In such cases, breastfeeding is not recommended.
However, after treatment is completed, many women are able to breastfeed from the unaffected breast. Women who undergo a lumpectomy or breast-conserving surgery may still have the ability to breastfeed from both breasts, depending on the extent of the surgery and the type of treatment received.
It’s important to discuss your breastfeeding options with your healthcare provider before starting treatment, as each case is unique. Some women may need to delay breastfeeding or explore alternatives, while others may be able to resume once treatment is finished.

Some treatments for pregnancy and breast cancer, particularly chemotherapy, can affect a woman’s fertility. Chemotherapy drugs may damage the ovaries, leading to temporary or permanent infertility. The extent of this risk depends on factors such as the type of chemotherapy, the dosage, and the woman’s age.
Before beginning treatment, it’s important to discuss fertility preservation options with your doctor. Women who wish to have more children in the future may consider egg or embryo freezing before starting chemotherapy. If you’re already pregnant, fertility preservation may not be an option, but your healthcare team will take steps to protect your fertility as much as possible.
In some cases, fertility may return after treatment, but women with pregnancy and breast cancer should discuss their reproductive goals with their oncologist and obstetrician to plan for the future.

The prognosis for women with pregnancy and breast cancer varies depending on the stage at which the cancer is diagnosed and how quickly treatment begins. Early detection and prompt treatment are crucial for improving outcomes. In general, studies suggest that the long-term survival rates for women with pregnancy-associated breast cancer are similar to those for non-pregnant women when matched for age and cancer stage.
However, there are some factors unique to pregnancy and breast cancer that can complicate the prognosis. Delays in diagnosis due to pregnancy-related breast changes and the limitations of certain treatments during pregnancy can lead to more advanced cancer stages at the time of diagnosis. This makes early detection, regular monitoring, and prompt medical care essential.
It’s important for women who have been treated for pregnancy and breast cancer to continue follow-up care after delivery, as regular screenings and medical check-ups are vital for monitoring potential recurrence.

Many women successfully go on to have more children after being treated for pregnancy and breast cancer. However, each case is unique, and future pregnancies depend on the type of treatment you received and your overall health.
If you’ve had chemotherapy, your fertility may be temporarily or permanently affected, but some women regain their fertility after treatment. Additionally, hormonal therapies, such as tamoxifen, which may be recommended after breast cancer treatment, often require a woman to wait before trying to conceive, as these drugs can affect the reproductive system.
Before attempting another pregnancy, it’s important to consult your oncologist and obstetrician to assess your health, ensure cancer is in remission, and create a plan for managing any ongoing treatments.