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Is it safe to treat breast cancer during pregnancy?

Dennis Citrin, MB, PhD,
pregnancy

Although not common, one in 3,000 women will be diagnosed with breast cancer during pregnancy, according to National Cancer Institute estimates. During pregnancy, a woman is already going through a lot of hormonal, emotional and physical changes. Adding a cancer diagnosis to the mix can cause fear and uncertainty for the future and the health of the baby. However, in most cases, it is safe to treat a mother for breast cancer when she is with child.

First, it is important to note that the changing hormones a woman’s body goes through during pregnancy does not cause breast cancer. The average age of a woman diagnosed with breast cancer while pregnant is between 32 and 38 years. This is often because more and more women are choosing to delay pregnancy until they are older for various reasons: financial stability, career focus, etc. Second, most breast cancers in pregnant women tend to be more advanced due to changes to the breasts—engorgement and tenderness. Most women do not detect a lump as easily as they would during pre- or post-pregnancy.

After receiving a breast cancer diagnosis, it is advised that a woman does not delay treatment. Some women, however, may choose to hold off on treatment until after the baby is born. This should be a conversation between the woman and her physician, discussing the appropriate options for her individual situation. For example, if a woman is further along in her pregnancy—at 37 to 38 weeks—she may choose to induce labor and undergo treatment following delivery.

As I mentioned before, most treatment for breast cancer is considered safe during pregnancy. Typically, surgery is recommended to remove the cancer. Chemotherapy, specifically doxorubicin and cyclophosphamide, are also considered to be safe during pregnancy during the second and third trimester. Hormonal therapy continues to be studied and at this time, has not shown harm to the baby. Radiation, however, is never recommended as this may be harmful to the fetus. 

Overall, studies have shown that pregnant women have slightly poorer outcomes than non-pregnant women, but this is believed to be linked to being diagnosed later on due to changes in the breasts. Additionally, termination of a pregnancy has not shown to have a difference on a women’s prognosis, and there is no evidence that breast cancer cells are transferred from a mother to the baby while in the womb.

I encourage every woman—pregnant or not—to perform regular self-breast examinations. If you do find a lump, notice any difference in the skin or nipple area, or are experiencing pain in the breast, talk to your doctor. If there is a concern, I recommend that a pregnant woman choose to have a screening via ultrasound as a mammogram involves radiation. Additionally, it is important to pay attention to good nutrition and supplement with plenty of folic acid. If breast cancer is found, don’t panic and don’t delay. The earlier the diagnosis, the better the prognosis. With advancements in treatment, we are seeing more positive outcomes with healthy mothers and babies after breast cancer.

Learn more about pregnant cancer patients’ options.

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