Dr. Ahmed Pregnancy is a period of advanced physiological activity, and getting diagnosed with breast cancer while pregnant is an additional strain. During this condition, it is crucial to ensure the safety of the developing fetus.
Breast cancer
Uncontrolled cell division in the breast cells leads to breast cancer. It is the 2nd most common type of cancer in women in the USA.
But over time, due to advanced techniques, the death rate of breast cancer is highly reduced due to timely diagnosis and modern treatment techniques.
Symptoms of Breast Cancer:
Symptoms of breast cancer depend on the stage. It may not be noticeable in the early stages but may present with obvious signs in the later stages.
Some of the common symptoms of breast cancer are:
- Inverted nipple
- Peeling of areola
- Change is the size or shape of the breast
- Lump in breast
- The orange-like appearance of the skin of the breast
- The main symptom is a palpable lymph node in the axilla or breast region which can be self-examined.
However, these symptoms become difficult to examine during pregnancy because of the changes that begin in order to prepare the breasts for breastfeeding
Breast cancer in pregnant women:
It is shown to occur in the age group between 32-38 years and above. There is a chance that one in every 3000 pregnant women may suffer from breast cancer.
In the modern era, as mothers delay having a child, the chances of cancer during pregnancy is increasing as they increase with age.
The problem with the diagnosis of breast cancer during pregnancy
During breastfeeding and pregnancy, the size of the breasts increases normally as they become more lumpy and dense.
So it becomes difficult to detect lumps formed during breast cancer by self-examination or even by mammography. Breast cancer is usually detected at later stages during pregnancy, making the situation more complicated.
Important issues caused by breast cancer while pregnant
Effect on fetus
Breast cancer has no effect on the fetus as cancer can’t spread from mother to fetus.
Discontinuation of breastfeeding
Breastfeeding and lactation should be stopped or discontinued in mothers suffering from breast cancer as if she undergoes chemotherapy, harmful chemical agents may affect the fetus through milk.
Moreover, in case of surgery, it should be stopped to decrease the blood flow toward lactating breasts.
Pregnancy, cancer, and survival
If a woman had breast cancer in the past, pregnancy doesn’t appear to affect their survival rates but it is advised by physicians to take 2 years gap in conceiving after the treatment of breast cancer.
Termination of pregnancy
The termination of pregnancy may ease the treatment of cancer but there is no strong evidence showing an increase in the survival rate of mothers by ending the pregnancy. Moreover, choosing to end a pregnancy is a difficult decision that only the mother can make.
Treatment of breast cancer in pregnant women
The main goal is the safety of the fetus during cancer treatment in pregnant mothers. Breast cancer can be treated in pregnant women in the following ways, depending upon the respective stage of cancer in them:
Radiotherapy
In radiotherapy, high-energy radiations are given from a source outside the body. These radiations are mostly X-rays that kill the rapidly dividing cancer cells.
Stages 1 and 2
In stages 1 and 2 of breast cancer, radiation is given after the baby is born for the safety of the baby, and radiation could be avoided during pregnancy as cancer is at its early stages.
Stages 3 and 4
These stages are called the last stage of cancer and affected pregnant individuals are given radiation after the 1st trimester or radiotherapy is delayed till delivery to avoid both the spread of cancer and ensure normal development of the fetus. Without these precautions taken, one can even undergo a miscarriage.
Surgery
Surgery is done in pregnant individuals suffering from breast cancer. It is done in the following ways:
Partial mastectomy
In this technique, tissue cells around cancer cells are removed with it and the rest of the breast is spared.
Radical mastectomy
In a radical mastectomy, the complete breast and surrounding lymph nodes are removed to eliminate all possible chances of cancer recurring.
Chemotherapy
It is a type of treatment in which chemical agents are given through the mouth or injected, which enter the bloodstream and kill cancer cells.
Chemotherapy should be avoided in the first trimester of pregnancy as this period is vital for normal fetal development.
It can be given after this period. However, it should be stopped 3 to 4 weeks before delivery as it increases the chances of bleeding and the spread of infections during delivery.
The following chemical agents have not caused any congenital anomalies in the fetus when used after 1st trimester:
- Taxanes
- Doxorubicin
- Fluorouracil
- Cyclophosphamide
Hormonal therapy
It is an advanced technique but is mostly avoided during pregnancy to ensure the normal development of the fetus and prevent any congenital anomalies.
Moral support
The one suffering from breast cancer while pregnant should be given moral support and therapeutic sessions to reduce her depression, increase her willpower, and make her believe that she can fight cancer as well as the baby born will also be normal as cancer is not seen to spread from mother to fetus.
In conclusion:
Breast cancer is not uncommon in pregnant women. Diagnosis may be delayed because a breast lump may be considered normal by the pregnant woman.
Treatment of breast cancer while pregnant may be difficult, as some drugs may harm the fetus, while others may not be effective.
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