Most breast cancers occur in women over 50. Breast cancer in pregnancy is a rare but difficult disease that occurs when a woman is diagnosed with breast cancer while expecting a child. This presents unique complexities due to the need to balance the health and safety of the mother and developing fetus.
According to the National Cancer Institute, women who are over 30 when they give birth to their first child have a higher risk of breast cancer than women who have never given birth. Let us tell you about the key aspects of breast cancer during pregnancy and its treatment.
Health Shots contacted Dr Pritesh Munot, Consultant Medical Oncologist and Hemato-Oncologist at Bombay Hospital, to know more about breast cancer during pregnancy, this Breast Cancer Awareness Month.
Risk of breast cancer during pregnancy
The prevalence of pregnancy-associated breast cancer has increased rapidly over the past 30 years, due to delayed pregnancy or older reproductive age. According to the study by Johansson et al., there is a 7% chance that pregnancy-associated breast cancer (PABC) will be diagnosed during pregnancy or in the postpartum period. Dr Munot says: “PABC is a very aggressive form of cancer, usually diagnosed at an advanced stage with an increased risk of localized relapse. » Here are some risk factors for breast cancer during pregnancy:
- Hormonal changes can make the tumor grow faster, making it harder to detect.
- Delayed diagnosis is common due to misinterpretation of symptoms as pregnancy-related.
- Women with high breast density are more likely to develop breast cancer.
- Women with a family history of breast cancer may face an elevated risk.
- Additionally, exposure to radiation, for example for medical purposes, can contribute.
- Having a pregnancy after age 30 also increases the risk of breast cancer.
- Excessive alcohol consumption is also a risk factor for breast cancer.
- Following a sedentary lifestyle and being overweight or obese after menopause also increases the risk of breast cancer.
Symptoms of breast cancer during pregnancy
Breast cancer during pregnancy may have symptoms such as a painless lump or thickening of the breast, nipple changes such as inversion or discharge, skin changes such as redness or dimpling, and persistent pain. Detecting these signs is crucial because hormonal changes during pregnancy can confuse you with the typical warning signs of breast cancer. If you notice a change in your breast, see a doctor.
Read also : 6 signs of breast cancer other than a lump
Diagnosis of breast cancer during pregnancy
Because the breast changes quite dramatically during pregnancy, clinical examinations and ultrasound imaging may not provide accurate results. Although these are the first steps in evaluation and diagnosis, mammography can be performed with minimal risk to mother and child; however, the role of mammography is limited in diagnosis.
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Under certain conditions, an ultrasound can diagnose breast cancer, explains Dr. Munot. A needle biopsy and chest X-ray with adequate protection are also considered safe during pregnancy. At the same time, magnetic resonance imaging can identify metastases but carries risks due to heating and cavitation.
Treatment of breast cancer during pregnancy
When PABC is diagnosed, treatment should be carefully considered to ensure the best outcomes for mother and child. The treatment approach depends on factors such as the stage of the cancer, the trimester of pregnancy and the mother’s general health.
Dr Munot says: “Although early-stage PABC (stages I and II) are treated in the same way as regular breast cancer, with modifications to protect the fetus, there is no defined treatment. for advanced-stage PABC (stages III and IV). . In some cases, surgery might be performed during pregnancy to remove the tumor, while chemotherapy and radiation might be considered after the first trimester. The care team will need to work closely with the patient to develop an individualized treatment plan that balances the needs of the mother and the safety of the unborn child.
Read also : Pain after breast cancer surgery is normal: tips for managing it
Can we breastfeed during PABC?
Although breastfeeding is the best way to bond with a newborn, breastfeeding is considered unsafe during or immediately after breast cancer treatment. When breast cancer treatment includes chemotherapy and radiation, some drugs can pass into breast milk and harm the baby. Once breast cancer treatment is completed, breastfeeding is possible. However, this should be discussed with the healthcare team depending on individual circumstances.
A PABC diagnosis can be difficult and overwhelming, but it is essential to ask questions about diagnosis, treatment, and recovery care at every step of the journey. It is important to have an open and honest discussion with your healthcare professional to ensure the best possible outcome for you and your baby.