Most breast cancers are found in women over 50 years of age. Breast cancer during pregnancy is a rare but challenging condition that occurs when a woman is diagnosed with breast cancer while she is expecting a child. It poses unique complexities due to the need to balance the health and safety of both the mother and the developing fetus.
According to the National Cancer Institute, women who are older than 30 at the time of the birth of their first child have a higher risk of breast cancer than women who have never given birth. Let us tell you about the most important aspects of breast cancer during pregnancy and its treatment.
Health Shots contacted Dr. Pritesh Munot, Consultant Medical Oncologist and Haemato-Oncologist, 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-related breast cancer has increased rapidly over the past thirty years due to delayed pregnancy or increasing childbearing age. According to Johansson et al.’s research, there is a 7 percent chance of pregnancy-related breast cancer (PABC) being diagnosed during pregnancy or 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 local recurrence.” Here are some risk factors for breast cancer during pregnancy:
- Hormonal changes can accelerate tumor growth, making it harder to detect.
- Delayed diagnosis is common because symptoms are misinterpreted as pregnancy-related.
- Women with high breast density are more likely to develop breast cancer.
- Women with a family history of breast cancer may be at increased risk.
- In addition, exposure to radiation, for example for medical purposes, can contribute.
- Pregnancy after the age of 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 increase the risk of breast cancer.
Symptoms of breast cancer during pregnancy
Breast cancer during pregnancy can present with symptoms such as a painless lump or thickening in the breast, nipple changes such as inversion or discharge, skin changes such as redness or dimpling, and persistent pain. Spotting these signs is critical because hormonal changes during pregnancy can confuse you with the typical warning signs of breast cancer. If you notice any change in your breast, see a doctor.
Also read: 6 signs of breast cancer other than a lump
Diagnosis of breast cancer during pregnancy
Because the breast changes quite drastically during pregnancy, clinical examinations and ultrasound imaging may not provide accurate results. While these remain the first steps toward evaluation and diagnosis, mammography can be performed with minimal risk to both mother and child; however, the role of mammography is limited in diagnosis.
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Under certain circumstances, an ultrasound exam can diagnose breast cancer, says Dr. Munot. Core needle biopsy and chest radiography with adequate shielding 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 both mother and child. The treatment approach depends on factors such as the stage of the cancer, the trimester of pregnancy, and the mother’s overall health.
Dr. Munot says: “Although early-stage PABC (stages I and II) is treated in the same way as regular breast cancer, with changes to protect the fetus, there is no established treatment for late-stage PABC (stages III and IV) . . In some cases, surgery may be performed during pregnancy to remove the tumor, while chemotherapy and radiation may be considered after the first trimester. The healthcare 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.”
Also read: Pain after breast cancer surgery is normal: tips for dealing with it
Can you breastfeed during PABC?
Although breastfeeding is the best way to bond with a newborn child, breastfeeding during or immediately after breast cancer treatment is considered unsafe. When breast cancer treatment includes chemotherapy and radiation therapy, some medications can pass into breast milk and harm the baby. Breastfeeding is possible after completion of breast cancer treatment. However, for individual circumstances this should be discussed with the care team.
Takeaway
A PABC diagnosis can be challenging and overwhelming, but it is essential to ask questions about the diagnosis, treatment, and recovery care at every stage of the journey. It is important to have an open and honest conversation with your healthcare provider to ensure the best possible outcome for both you and your baby.