Breast Cancer and Pregnancy
Breast cancer found during pregnancy, breastfeeding or within a year following the birth of a baby is considered Pregnancy-associated Breast Cancer. It is a comparatively rare phenomenon with the incidence rate varying from 1/3000 to 1/10000.
During pregnancy, the menstrual cycles stop in the mom-to-be and the levels of estrogen and progesterone go up. Prolactin, a hormone that tells the breasts to prepare for nursing, also increases during pregnancy.
Such changes in the hormone cause the breasts to change. They tend to feel larger, lumpy, and tender. This can make it harder for the mom-to-be or her doctor to notice a lump caused by cancer until it gets quite large.
Also, the increase in hormones tends to make a hormone-dependent variety of Breast Cancer to grow faster. Cancer tends to be of large size and it is usually at an advanced stage at the time of diagnosis.
Women diagnosed with breast cancer can possibly continue their pregnancy and take treatments as per the level of their pregnancy concurrently. They can proceed and deliver healthy babies. While it is not a blanket statement for all breast cancer patients, it depends on the age of the patient.
When deciding about pregnancy, it is important for the doctors to consider and talk to the patient about her age, family size and type of breast cancer to check aggressiveness and the risk of recurrence.
The diagnostic and staging investigations are limited to Ultrasound, MRI, and biopsy as we cannot expose a woman to radiation during pregnancy.
Treatment During Pregnancy
Surgery can be done during the pregnancy; it does involve some mild risk, associated with anesthesia, of early induction of labor/abortion and/or exposing the pregnant woman to infection.
Chemotherapy can be given during the 2nd or 3rd trimester. During the 1st trimester, chemotherapy can affect the organogenesis and fetal development. Also, it is avoided during the last three weeks of pregnancy
Radiation, hormonal and targeted therapy have to be avoided during pregnancy as they are more likely to adversely affect the baby.
It is also important to know that pregnancy after breast cancer does not increase a woman’s risk of a relapse.
The new Mom may experience some difficulty in breastfeeding post-surgery and radiation, but the possibility is higher with probable lower milk production on the treated side. Chemotherapy drugs can also be present in the milk. Radiation also definitely affects the milk production.
It is very important that the oncology team works very closely with gynecologists & fetal medicine specialists.
Post Breast Cancer Pregnancy
Breast cancer is the most common type of cancer among women. However, if intervention takes place at the right time then this factor cannot discourage motherhood.
As per many medical experts, pregnancy is possible for survivors of breast cancer since it does not increase risk of recurrence and neither does it cause any harm to the baby.
There were concerns raised by doctors earlier that there is increased risk of cancer recurrence in women who contemplate pregnancy, but the latest research show that there is no such phenomenon – there is no increased risk in women who conceive in comparison to women who do not.
Dr. Rohan Khandelwal, the Breast Cancer Specialist in Gurgaon at the Breast Centre, CK Birla Hospital to learn more about breast cancer. Book your appointment today!