Breast cancer during pregnancy is uncommon, occurring in about 1 in 3,000 women, yet it’s the most frequent malignancy found in pregnant women. Early detection is key, but it can be challenging. Pregnancy and breastfeeding cause natural changes in breast tissue—like swelling and tenderness—that can make it harder to spot potential issues. If you notice unusual changes, don’t ignore them. Here’s what to look out for:
- A lump or thickened area in the breast or underarm.
- Changes in breast size or shape.
- Dimpling or puckering of breast skin.
- A nipple that turns inward.
- Fluid from the nipple (especially if it’s bloody and not breast milk).
- Red, scaly, or swollen skin on the breast or nipple.
- Skin dimpling that resembles an orange peel.
Treatment Options During Pregnancy
When it comes to breast cancer treatment during pregnancy, a multidisciplinary approach is crucial. This means a coordinated team of specialists, including a gynecologist, breast surgeon, oncologist, and radiologist, working together to give you the safest and most effective care.
Here are some key treatment options:
Surgery
Surgery is generally safe at any stage of pregnancy, and it’s often the first step in treatment. Common procedures include:
- Lumpectomy: Removing the tumor and some surrounding tissue.
- Mastectomy: Removing the entire breast if necessary.
- Some lymph nodes in the armpit may also be removed for further examination.
Reconstructive surgery is usually delayed until after childbirth to allow hormones to settle.
Radiotherapy
Radiation is typically postponed until after the baby is born to avoid any potential risks to the fetus.
Chemotherapy
While chemotherapy is not recommended during the first trimester (when the baby’s organs are forming), it may be safe during the second and third trimesters. The treatment plan will be personalized based on your cancer type, and your oncologist will carefully choose options that protect both you and your baby.
Hormone Therapy
Hormone treatments are generally delayed until after delivery, as they can pose risks during pregnancy.
Breastfeeding After Treatment
Breastfeeding from a treated breast may not be possible, especially if it has undergone surgery or radiation, but the unaffected breast can still produce milk. Importantly, breastfeeding does not increase the risk of breast cancer recurrence.
Future Pregnancies
Most doctors recommend waiting at least two years after completing breast cancer treatment before trying to conceive again. This waiting period allows time to monitor for any recurrence, which is most likely to happen within the first two years after treatment.
For those considering future pregnancies, options such as freezing eggs or embryos before starting cancer treatment may be available. Your oncologist can also discuss chemotherapy choices that might have a lesser impact on fertility.
Navigating Breast Cancer and Pregnancy
Being diagnosed with breast cancer during pregnancy is understandably overwhelming. However, rest assured that your medical team is dedicated to both your health and the safety of your baby. Many women with breast cancer go on to have healthy pregnancies and deliver healthy babies.
Remember, you’re not alone—support, specialized care, and effective treatments are available.