By: Laurie Edwards for Uterus1For women who suffer from breast cancer during pregnancy, recent studies provide several reasons to be encouraged: A combination of diagnostic tools – including mammograms and ultrasound – can get breast cancer accurately diagnosed during pregnancy and treated safely. The key, experts urge, is to avoid prolonging medical treatment.
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Take care of yourhealth during pregnancy too
Be vigilant – normal hormonal changes and lactation during pregnancy can make it more difficult to detect symptoms of breast cancer.
The earlier the better for detection – if you notice symptoms such as nipple discharge, skin changes or persistent swelling of the breast, consult your physician.
Breast cancer affects between 1 in 3,000 and 1 in 10,000 pregnant women, though the number may rise as more older women opt to have children.
While surgery and radiation is not suggested for pregnant women, ultrasounds and mammograms are safe, effective diagnostic tools, and there are certain types of chemotherapy that effectively treat more invasive cancers without harming the fetus.
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The earlier cancer is detected and treated the better the overall outcome, and since many pregnant woman delay treating their cancer until after they deliver their babies, this latest information could have huge significance for the estimated 1 in 3,000 to 1 in 10,000 women who develop breast cancer during pregnancy.“Ultrasound identified 100 percent of cancers in our study, and mammography demonstrated 90 percent,” said lead researcher Wei T. Yang, associate professor of diagnostic radiology at Houston’s M.D. Anderson Cancer Center’s Breast Imaging Section. “We want young women to know that symptomatic breast cancer that occurs during pregnancy can be imaged, diagnosed and treated while pregnant, so they should not wait to seek medical attention if they start to have suspicious symptoms.”
Pregnancy results in bodily changes that can make detecting breast cancer even more difficult, namely hormonal changes and lactation that can cause an increase in breast volume and tenderness. Common symptoms of breast cancer in pregnant women include painless palpable masses, nipple discharge, skin changes and persistent unilateral breast swelling.
In addition, younger women of childbearing age usually do not have the routine mammograms that would detect cancer, so being vigilant and seeking help before the cancer becomes advanced is key.
The study, published in a recent issue of Radiology, recommends using ultrasound as the first mode of diagnostic inquiry, but does not rule out mammography. With proper shielding from radiation, mammograms are considered safe for both mother and baby. In fact, experts actually suggest the two diagnostic modes have complementary roles since mammograms detect cancerous calcification in the breast that an ultrasound might miss.
While it is certainly good news that ultrasounds and mammography can work together to detect breast cancer early and effectively, there are, of course, certain accommodations physicians must make for pregnant women, most notably finding alternatives to surgery and radiation.
“Although local and systemic treatment strategies for a pregnant patient with breast cancer are similar to those for a non-pregnant patient, some modifications may be necessary in pregnant patients to minimize fetal harm,” the study authors wrote. “For example, breast irradiation, chest wall irradiation, or both are postponed until after delivery because of risks of fetal exposure to radiation.”
Because it can be so difficult to identify breast cancer symptoms in the changing bodies of pregnant women, often they are the patients whose cancer is already advanced by the time it is detected. Fortunately, the Houston study also found that a type of chemotherapy that is anthracycline-based is safe for pregnant women in their second and third trimesters.
Awareness that breast cancer is both detectable and treatable during pregnancy is especially significant given that more women are delaying childbirth until they are older.
British researchers found that incidences of pregnancy-related breast cancer are likely to continue to rise as older women decide to have children, which underscores the need for further studies.
“This is a real double whammy for women as it’s a unique combination of two major life events… The challenge for health professionals is treating these women as a distinct group with specific needs compared to other women with breast cancer,” said Catherine Jack, Macmillan Lecturer at the School of Healthcare at the University of Leeds.
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