• Shruti GOCHHWAL

Breast Cancer During Pregnancy

1 in every 8 women are at risk of developing breast cancer. Moreover, the risk further increases for women as they age, especially if they have children later in life.

Breast cancer is the second most common malignancy affecting pregnant women and approximately every 1 in 3000 pregnant women are at risk.

The term “Pregnancy-associated breast cancer” or PABC is applied to any woman who gets diagnosed with breast cancer during their pregnancy or in the first postpartum year.

How Pregnancy Affects Breast Cancer

Some researchers believe that the outcome of breast cancer in pregnant women does not differ from non-pregnant women but there are some few contradicting studies that discuss the possibilities of pregnancy slowing down tumor growth and abnormal cell division.

The one thing that’s clear is that pregnancy significantly makes the diagnosis and treatment of breast cancer more difficult.

As of yet, there are no reports that prove that breast cancer can harm the growing fetus.

Treatment

Treatment is complicated, complex, and highly calculated in order to ensure progress of the mother’s condition while ensuring that the health of the growing fetus is not compromised.

The main goal of the treatment is to either cure the condition or control tumor growth.

Surgery

Breast Tumor Removal, Credit: Pixabay


Surgery

Breast cancer can be safely cured by removing the tumor and the lymph nodes surrounding, without having any negative side-effects on the baby.

The surgical procedure can be conducted by the mastectomy, a process of removing the entire breast or by lumpectomy, a process where the breast is conserved and only the cancerous part is removed.

The course of the surgical option is decided by the doctor.

Axillary lymph nodes in the armpit should also be checked and observed in case the cancer has spread. It can be examined by axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB) method.

A popular concern among pregnant women is that the anesthetic used during surgery may be harmful to their growing fetus- This is not always true.

Sometimes, the anesthetic is harmful but at the earlier stages of pregnancy, the mother can undergo an anesthetic surgery with very low risk.

The surgeon, anesthesiologist, and obstetrician work together and determine the best option, technique, and drug choice.

Treatment after Surgery

In order to lower the risk of the cancer coming back, treatments like chemotherapy, radiation therapy, hormone therapy or targeted therapy are conducted. Most of these treatments are performed after childbirth.

Chemotherapy

Chemotherapy, Credit: Wikimedia Common


Chemotherapy is generally carried out after surgery and especially cannot be performed during the first three months of pregnancy as it compromises the baby’s growth and risks miscarriages. It is also not recommended within 3 weeks of delivery because it can lower the mother’s blood cell counts.

Treatments of radiation therapy must strictly be on hold until childbirth as it may cause miscarriage, birth and growth rate defects, or childhood cancer.

Another treatment that must be on hold is hormone therapy as it will interfere with the normal levels of pregnancy hormones in the mother that is required and essential for the growth and development of the fetus.

Breastfeeding

Breastfeeding, Credit: Peakpx


Safety: Is Diagnosis and Treatment Safe?

Diagnosis

Breast cancer is generally diagnosed and detected by mammograms or breast x-rays. This test can still be safely conducted in pregnant women by using a shield to protect the baby from harmful radiations.

Treatment

Depending on the size, location, rate, and extent of the tumor, your doctors will explore all possibilities and options for treatment.

There is always a risk that has to be taken when it comes to situations like these. However, it is generally safe to treat breast cancer during pregnancy. Surgeries are usually performed immediately after detection with necessarily after-surgery-treatments post-childbirth.

Limitations: Is Breastfeeding Possible?

Breastfeeding is not advised prior to or post-surgery as it interferes with the blood flow in the breast and could also increase the risk of infection.

Moreover, treatments like hormone, radiation, and chemotherapy can make your breast milk harmful as the harsh drugs used can possibly enter the breast milk and poison the infant.

Conclusion

With proper care, treatment, and various options and techniques, breast cancer is manageable and highly treatable during pregnancy.

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