Symptoms of breast cancer are same as non-pregnant women and goals are also similar – getting treatment of breast cancer whenever possible. However, treatment and diagnosis of breast cancer during pregnancy is little bit complicated. Treatment and diagnosis depend upon the cancer stage and pregnancy trimester you are in.
Diagnosis of breast cancer
Your breast change during pregnancy. Your body becomes ready for breastfeeding and the breast tissues become more dense, which make difficult to find changes in the breast.
Concern your physicians, they will examine, if they will find any changes in your breast. They will refer you to the breast clinic.
First, test you will have an ultrasound scan because sound waves are safer for your baby. You can also have a mammogram. To protect your baby they will shield your baby from the radiation.
Some tests that doctors usually don’t recommend such as bone scans and CT scans due to risk to the baby.
Treatment of breast cancer
If you have breast cancer and also pregnant, then your option is complicated than normal, get expert help.
The main aim is to get better treatment without putting the baby at risk. Pregnant women can treatment safely, although the treatment type and timing can be affected by pregnancy.
Your treatment during pregnancy will depend upon.
- Location of the tumor
- Size of the tumor
- Metastasis of tumor.
- The time, you are in pregnancy or trimester you are in.
- Your Health and personal preferences
Removing cancerous cells or tumor in the breast and lymph nodes is major part of treatment of breast cancer in the early stage.
Surgery is safer than others during pregnancy. You can have surgery during any time of the pregnancy.
Anesthesia is used surgery can reach to the fetus, but it doesn’t cause serious problem in your pregnancy.
Breast reconstructive surgery during the cancer, removing operation can make operation much longer so it should be delayed until after the baby is born and use of anesthesia.`
Mastectomy is recommended for pregnant women because radiation therapy is needed after afterward.
If radiation is given to pregnant women, it can affect the fetus. But delaying the radiation can increase the chance of recurrence.
But if the breast cancer found in the third trimester them normal surgery (lumpectomy) can be the option because there can be little delay in the radiation therapy.
2. Radiation surgery
Radiation therapy is needed after surgery of removing cancer cells (lumpectomy).
So removing the whole breast (mastectomy) is usually recommended for women who are in their first trimester and want to keep their child.
If women in their second or third trimester, lumpectomy may be considered. In this case radiation can be delayed until delivery.
Chemotherapy is not given to women who are in their first trimester because it can cause miscarriage or other drug-related birth defects.
Most of the baby’s body parts developing during this stage and chemotherapy aren’t safe during this time.
For many it was thought that all chemotherapy would harm the unborn baby. But this is not the case, studies have shown that there are some chemotherapy drugs which can be used safely in second or third trimester that don’t increase the risk of any birth related defects.
But Although chemotherapy should not be given after 35 weeks of pregnancy or within three weeks of planned deliver dates.
Targeted therapy or hormone therapy
Drugs that are used in targeted therapy for HER2-positive breast cancer, such as Trastuzumab (Herceptin), Pertuzumab (Perjeta), Ado-trastuzumab emtansine (Kadcyla, also known as TDM-1), Lapatinib (Tykerb), Neratinib (Nerlynx), etc. are the important part of this therapy.
In non-pregnant trastuzumab is used as adjuvant treatment after surgery and all the other drugs are used to treat advanced cancer.
But as a side effect of these drugs can damage the heart of some women, which can lead to congestive heart failure, but these are for a short time and gets better as women stop taking these drugs.
Lapatinib which is also a drug used in this therapy can also cause a hand-foot syndrome in which your feet and hands re and sore.
Targeted therapy cannot be used at any time during pregnancy due to risk to the fetus, even they can cause death to the fetus.
Is breastfeeding safe after diagnosis of the breast cancer?
The study shows that breastfeeding can reduce the risk of breast cancer by 30%, but what is you are diagnosed with breast cancer or during the treatment of breast cancer.
Is breastfeeding safe during breast cancer?
In most cases, the doctor will not recommend breastfeeding if you are diagnosed with breast cancer.
Breast cancer treatment can affect your milk duct which can cause a negative effect on the baby.
Breastfeeding should be avoided while breast cancer being treated with chemotherapy, hormone therapy, targeted therapy or radiation therapy.
But if you are wishing to breastfeed, you should talk to your doctor.
Is anesthesia safe for pregnant women?
Surgery carries little risk for baby in the fetus. But there is some time during pregnancy when anesthesia may riskier. Your doctors need to work to decide the best time for the operation.
HealthyLifeNU “Breast cancer: Symptoms, Types, Treatment, Risk Factors, Prevention, Stages” “https://healthylifenu.com/breast-cancer/”
American Cancer Society “Treating Breast Cancer During Pregnancy” “https://www.cancer.org/cancer/breast-cancer/treatment/treating-breast-cancer-during-pregnancy.html”
Breast Cancer Care “Breast cancer during pregnancy” “https://www.breastcancercare.org.uk/information-support/facing-breast-cancer/breast-cancer-in-younger-women/fertility-pregnancy-breast-cancer-treatment/breast-cancer-during-pregnancy”
American Cancer Society “Targeted Therapy for Breast Cancer” “https://www.cancer.org/cancer/breast-cancer/treatment/targeted-therapy-for-breast-cancer.html”