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Breast Cancer and Pregnancy

Breast cancer is the most common cancer in pregnant women and tends to affect women in their mid-30s. Although pregnancy doesn't cause breast cancer, the hormonal changes in the body during pregnancy can accelerate its growth.The disease can be devastating to both the mother and child, so it is essential that pregnant women and their health care providers continue to perform routine breast exams throughout pregnancy. Any suspicious lumps and symptoms should be evaluated.

Because many changes take place in a woman's breasts during pregnancy, it can be more difficult to identify small masses, or lumps, during pregnancy. Breast masses can be mistaken for a normal change due to pregnancy. In addition, breast cancer tumors in pregnant women are often larger and more advanced by the time they are detected than lumps in women of the same age who are not pregnant. 

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Late Stage Breast Cancer (Stage III and IV)

First-trimester radiation therapy should be avoided. Chemotherapy may be given after the first trimester as discussed in the section on Early Stage Breast Cancer. Because the mother may have a limited life span (most studies show a 5-year survival rate of 10% in pregnant patients with stage III and IV disease), and there is a risk of fetal damage with treatment during the first trimester,[1,2] issues regarding continuation of the pregnancy should be discussed with the patient and her family. Therapeutic...

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How Is Breast Cancer Diagnosed in Pregnant Women?

The best thing you can do while pregnant is to see your health care provider regularly. These doctor visits, called prenatal (or "before birth") visits, are very important in keeping both you and your baby in the best possible health. During these visits, your health care provider will perform a breast exam to check for suspicious breast changes.

It is also important for you to regularly perform self breast exams at home. Your doctor or nurse can teach you how to do this properly.

If a suspicious lump is found, your doctor should perform a biopsy. A mammogram may not be as helpful because of the increased density of the breasts due to pregnancy. A mammogram is usually 80% accurate. An ultrasound might be done as well to assess the extent of disease and guide the biopsy.

During the biopsy, a small sample of the suspicious tissue will be removed with a needle or by making a small cut. This sample is then thoroughly examined using a microscope and other methods to detect any cancer cells.

 

What Happens to my Baby if I Have Breast Cancer?

Pregnancy termination will not improve the mother's chances of surviving breast cancer. In addition, there is no evidence that breast cancer can harm the baby. What may harm the baby are some of the treatments for breast cancer.

If the cancer is still in the early stages (Stage I or II), your doctor will most likely recommend that you have surgery to remove either the suspicious lump (lumpectomy) or the entire breast (mastectomy). Mastectomy is the preferred surgery in the first and second trimester; radiation therapy can't be started until after pregnancy because it can harm the baby. Lumpectomy is usually an option for women diagnosed with breast cancer in the third trimester. Surgery, in general, is safe during any trimester of pregnancy.

During breast cancer surgery, the surgeon will examine the lymph nodes to see whether any are affected and will (usually) remove the lymph nodes where the cancer is most likely to have spread. If it is necessary to give chemotherapy, your doctor will usually wait until after the first trimester to reduce the chances that it will harm the baby.

If breast cancer is more advanced (Stage III or IV), the situation can become very complicated. If radiation is needed to treat the cancer, it can be very hard to protect the baby. Additionally, these cancers usually require both surgery and chemotherapy, so the risk of harming the baby is much higher. There have been instances where the cancer is advanced to the point where any treatment is not likely to add more than a year or two to the woman's life. In these cases, whether or not to undergo the treatment and risk harming the baby can be an agonizing decision for both the woman and her family.

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