Breast Cancer and Pregnancy
Pregnancy can be such an exciting time in someone’s life that breast cancer may be the last thing on their mind. While rare, approximately 1 in 3,000 expectant mothers will develop breast cancer during their pregnancy (American Cancer Society, 2022) . Pregnancy does not cause breast cancer, but it will affect diagnostic testing as well as treatment options. Let’s look at the signs and symptoms of breast cancer and how pregnancy can impact treatment.
Signs and Symptoms of Breast Cancer
Lumps or thickening on the breast or underarm areas
Changes in size/shape of the breast
Dimples or puckering of skin on the breast
Fluid (other than breast milk) draining from the nipple
Scaly, red, or swollen skin on the breast
Because hormones cause breasts to go through changes during pregnancy, small lumps may be hard to detect. Therefore, breast exams are an important part of both prenatal and postnatal care (National Cancer Institute, 2022) . If you find something of concern, tell your medical provider right away so further testing can be ordered.
Testing Options
There are multiple options for diagnostic testing if necessary. Ultrasounds have been shown to be 100% effective in detecting masses and are considered safe during pregnancy as they do not use any radiation (National Library of Medicine- National Center for Biotechnology Information, n.d.). Mammograms are another useful tool and are regarded as generally safe due to the low amount of radiation used. Other tests such as CT scans, MRIs, PET scans use radiation or injected dyes and are typically avoided (American Cancer Society, 2022) .
Treatment Options
Treatment options will vary depending on multiple factors (American Cancer Society, 2021) . It is important to discuss all options with your medical provider. Some of the factors that will affect your treatment are:
Size of the tumor
Location of the tumor
If the cancer has spread
How far along you are in your pregnancy
Your general health
Surgery is a first-line treatment for breast cancer during pregnancy. While the surgery itself is considered generally safe, the medications used for anesthesia may pose a risk of harm to the unborn baby. Chemotherapy can be used for the 2nd and 3rd trimesters but is typically withheld a few weeks before delivery to avoid complications during birth. It is not used during the 1st trimester due to harmful effects on the development of the fetus. Radiation and hormone therapy are avoided until after delivery due to this same reason (American Cancer Society, 2021) .
The goal of any treatment is to cure the mother of cancer or slow the disease progression if a cure is not possible. There are no studies that show cancer can spread to the unborn baby, but the safety of the fetus should be considered when formulating a treatment plan. Termination of pregnancy is not typically recommended. However, this option may be discussed if the cancer is at an advanced stage early in pregnancy and aggressive treatment is needed (American Cancer Society, 2021).
Whatever treatment plan is decided upon, getting a diagnosis of breast cancer while pregnant can be emotionally challenging, and finding a support group may be helpful. Check out the support groups offered by Pickles and Ice Cream Georgia.
Blog Writer: Rebecca (Becca) Cook BSN, RN
Blog Reviewer: Leslie Catalano MSN, LEC
References
American Cancer Society. (2021, October 27). Treating Breast Cancer During Pregnancy. Retrieved from American Cancer Society : https://www.cancer.org/cancer/breast-cancer/treatment/treating-breast-cancer-during-pregnancy.html
American Cancer Society. (2022, January 1). Finding Breast Cancer During Pregnancy. Retrieved from American Cancer Society: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/finding-breast-cancer-during-pregnancy.html
National Cancer Institute. (2022, April 14). Breast Cancer Treatment During Pregnancy (PDQ®)–Patient Version. Retrieved from National Cancer Institute:
https://www.cancer.gov/types/breast/patient/pregnancy-breast-treatment-pdqNational Library of Medicine- National Center for Biotechnology Information. (n.d.). Retrieved fromPregnancy-Associated Breast Cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410508/