Although uncommon, breast cancer can sometimes occur in some mothers-to-be. Although hormonal changes during pregnancy can lead to rapid disease progression, pregnancy does not cause cancer.
Breast tissue thickens during pregnancy, making it difficult to detect small bulges or lumps. Therefore, by the time breast cancer is detected, the lump is usually large and in a more advanced stage.
This makes it especially important to screen for breast cancer during pregnancy. Any lumps or suspicious symptoms require medical attention.
How is it diagnosed?
The best option during pregnancy is regular medical visits, also known as prenatal visits, which are crucial to keep the pregnancy and fetus healthy. During a maternity visit, it may be possible to detect breast changes.
Self-exams should also be performed regularly at home to also help detect breast changes. If you are unsure how to perform a breast self-examination, your doctor or nurse can provide guidance.
Mammograms are very safe during pregnancy, but may not be useful due to increased breast density. A 3-D mammogram may be a better option.
If a suspicious lump is found, your doctor will usually perform a biopsy to obtain a sample of suspicious tissue through a biopsy needle or by cutting a small piece, examining the sample tissue under a microscope, and using other methods to look for cancer cells.
The doctor may also perform an ultrasound to assess the extent of the disease and to guide the biopsy.
How will having breast cancer affect the fetus?
Terminating a pregnancy does not increase a woman’s chances of beating breast cancer. In addition, there is no evidence that the cancer is harmful to the fetus. But there are risks associated with treatment.
Usually, it is safe to have surgery during pregnancy. If the cancer is early, your doctor is more likely to recommend removal of the suspected mass (breast-conserving surgery) or the entire breast (mastectomy). If the pregnancy is early or mid-stage, mastectomy is the best option. Breast-conserving surgery is usually indicated for women diagnosed with breast cancer in late pregnancy. Radiotherapy is not usually started before delivery because of the risk of harm to the fetus.
During breast cancer surgery, the surgeon will check the lymph nodes to determine if there are lymph node metastases. The lymph nodes where the cancer is most likely to spread and reach first are usually removed. If chemotherapy is needed, doctors usually recommend it after early pregnancy to reduce the chance of harming the fetus.
Advanced breast cancer usually requires surgery and radiation therapy, so the risk to the fetus is higher. The decision of whether to undergo treatment is a very difficult one. Discuss with your family and doctor to determine the appropriate treatment.
Can women with breast cancer breastfeed?
There is no evidence that stopping breastfeeding improves cancer prognosis.
It is usually possible to breastfeed when you have breast cancer, but you should consult your doctor to determine what is best for the mother and baby. If you are receiving chemotherapy, you should not breastfeed. Many potent chemotherapy drugs also pass into the baby’s breast milk.