Most cancers in pregnant women are found during a clinical breast exam. Pregnant women get clinical breast exams as part of prenatal care. Younger women (under age 40) usually do not get screening mammography. Screening mammography is not used in pregnant women because the radiation may harm the fetus.
When a lump is found during the first trimester, tests such as breast ultrasound (rather than mammography) are used to check it for breast cancer. After the first trimester, a pregnant woman may have a diagnostic mammogram with a shield covering her abdomen to protect the fetus.
Breast cancers in pregnant women may be diagnosed at a more advanced stage than in non-pregnant women . Breast cancer can be hard to detect in pregnant women because the increased size and change in texture of the breasts during pregnancy can make smaller cancers hard to feel.
There are special treatment concerns for pregnant women who have breast cancer. Although cancer itself does not seem to affect the fetus, certain breast cancer treatments can be harmful . Your treatment plan and the timing of the treatment are selected to specifically treat your cancer as well as protect the fetus.
Breast cancer surgery is safe during pregnancy. Although the anesthesia used during surgery can cross the placenta to the fetus, it does not appear to cause birth defects or serious pregnancy complications . Breast reconstruction, however, should be delayed until after the baby is born to avoid further anesthesia and the chance of blood loss.
Mastectomy is usually recommended for pregnant women who are in their first trimester and want to continue their pregnancy .
Some women in their second or third trimester may consider lumpectomy (also called breast conserving surgery) . However, radiation therapy is needed with lumpectomy and radiation can harm the fetus. So, women who have a lumpectomy wait and have radiation therapy after the baby is born. This delay does not worsen prognosis .
Some women in their second or third trimester may also have chemotherapy before surgery (neoadjuvant chemotherapy) .
Learn more about surgery.
Learn about breast reconstruction.
Learn more about radiation therapy.
Learn more about neoadjuvant chemotherapy.
Chemotherapy is not given during the first trimester, as this is the time when the chances for drug-related birth defects and miscarriage are greatest [127-128].
During the second and third trimesters, some chemotherapy drugs can be used safely [14,129]. However, chemotherapy should not be given after week 35 of pregnancy or within three weeks of the due date (or planned delivery date) .
This gives a woman time to recover from chemotherapy before delivery. Many women diagnosed in their third trimester often wait and have chemotherapy after giving birth. Learn more about chemotherapy.
Hormone therapies (tamoxifen and aromatase inhibitors) and targeted therapies (such as trastuzumab (Herceptin)) are not used at any point during pregnancy because of risk to the fetus [14,128].
Learn more about hormone therapy.
Learn more about trastuzumab.
Gina Samet, survivor & mother
Prognosis for women with breast cancer is similar to that of non-pregnant women, when age and cancer stage are taken into account (more on cancer stage) . Ending a pregnancy does not improve prognosis .
If you have breast cancer while you are pregnant and wish to breastfeed, talk with your health care provider.
Breastfeeding should be avoided while being treated with radiation therapy, chemotherapy, hormone therapy or targeted therapy.
Some treatments (such as radiation therapy and surgery) may make it difficult to nurse from the treated breast.
Facts For Life: Breast Cancer in Pregnancy
Facts For Life: Young Women & Breast Cancer
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