Breast Cancer During Pregnancy: A Delicate Situation - December 2024

Some positive results can bring joy, while others can bring tears. While rare, pregnancy results can accompany cancer diagnosis; breast cancer being the most common. About 1 in every 3,000 pregnant mothers get breast cancer in their lives. As more and more women delay pregnancy until their 30s and 40s, the risk of breast cancer rises. For those fighting breast cancer while pregnant (or if you know someone who is), here’s what you need to know. Breast Cancer and Pregnancy Breast cancer is one of the most common cancers diagnosed during pregnancy, second only to melanoma. Pregnancy-associated breast cancer (PABC) is when a woman gets breast cancer during pregnancy or shortly after giving birth. The most important thing to note is that the pregnancy itself does not cause breast cancer. However, pregnancy hormones (such as oestrogen and progesterone) can accelerate the growth of certain tumours. This can further complicate the diagnosis and treatment of pregnancy-related breast cancers. Diagnosing Pregnancy-Related Breast Cancer PABC Diagnosing breast cancer during pregnancy can be challenging for a number of reasons: pregnancy symptoms, screening methods, lack of awareness. Delayed detection is also the most dangerous obstacle that comes with diagnosing PABC. Some women who experience breast cancer symptoms may not even realise it’s serious. Moreover, some mothers may often mistake the telltale signs of breast cancer, such as tenderness, swelling, lumps, changes in texture, for normal pregnancy-related breast changes. Often the other more intense pregnancy symptoms can mask or cloud the emerging cancer symptoms, making it hard for women to notice any warning signs. Second, most screening methods used to catch breast cancer, such as MRIs and mammograms use radiation. Therefore, doctors will usually discourage them due to the potential harm to the unborn baby. However, recent studies show that with proper shielding, MRIs and mammograms are safe during pregnancy. Ultrasounds are also another safe method. Finally, the lack of awareness and education among women on PABC is also a factor in delayed detection. Some women may not even know that they can still get cancer while pregnant. Treatments for PABC Due to the harsh nature of cancer treatments, many options may not be available for pregnant women. This is another obstacle in assuring survivability of this disease. The most important part of recommending cancer treatments for pregnant women is to tailor them to the stage of cancer and the stage of pregnancy. The primary goal of doing so is to minimise the potential risk to the unborn baby as much as possible. Here are the recommended treatment options for PABC: Surgery: The first line of treatment for breast cancer in pregnant women and poses the least risk to the baby. Both lumpectomy (removal of the tumour) and mastectomy (removal of the entire breast) are relatively safe during all trimesters. Chemotherapy: Recommended depending on the type and stage of the cancer but avoided during the first trimester when the fetus is most vulnerable to potential harm. Safer in the second and third trimesters, as the risk of birth defects decreases. Radiation Therapy: Avoided during pregnancy, due to significant risks to foetus, particularly in the first and second trimesters. Delayed until after the baby is born. Hormonal Therapy and Targeted Therapy: Doctors tend to postpone hormone treatments until after delivery due to the potential risks to the foetus. Timing of Delivery: Doctors may recommend delivering the baby early, allowing the mother to begin more aggressive cancer treatments. All in all, the success of cancer treatments for pregnant mothers rely on a coordinated effort between multiple healthcare providers. Oncologists, obstetricians, surgeons, and paediatricians must work together to create a treatment plan that prioritises both the mother’s survival and the baby’s safety. Safety of Unborn Baby As mentioned, cancer treatments during pregnancy depend on how far along the mother is and what stage the cancer is in. However, even the safest cancer treatments can pose some level of risk to the wellbeing and safety of the unborn foetus. Complications during surgery can arise, and chemotherapy has shown to affect a foetus in various ways. For example, getting chemotherapy in the second and third trimesters can leave minimal but long-term effects on the baby’s development. Some studies also suggest a slightly higher risk of low birth weight and premature delivery. That said, most long-term follow-up studies show relatively positive results. Children born to mothers who underwent cancer treatment during pregnancy tend to develop normally. Nevertheless, any doctor will take great care in ensuring that both mother and baby remain unharmed during the entire length of pregnancy, regardless of the cancer treatment used. The Importance of Social Support Pregnancy alone can be very stressful, especially for a new mother. Pregnancy symptoms and other worries about motherhood is challenging enough. Getting a cancer diagnosis on top of it all can be a burden to bear. The natural risk of depression and anxiety that comes with pregnancy may increase with the stressful experience of getting cancer treatments. That’s why it’s important to have a close circle of loved ones who can support and encourage you. However, this may not be enough. Mothers may also want to join a support group with other cancer patients and survivors. Doing so can give pregnant mothers the hope and strength they need to keep fighting. Surviving Cancer for Motherhood Countless women have gotten breast cancer during pregnancy and won the fight. They have overcome two of the hardest things known to man: bringing a child into the world and surviving one of the deadliest diseases in the world. If you are currently in the same situation, do not lose hope, mummies! With rapid advancements in cancer treatments, more and more people have successfully fought cancer and won. If it’s possible for them, it’s possible for you. Remember, you are a mother now and there is no one more worthy of fighting for than the child in your belly waiting to greet you for the first time. You've got this! Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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