Pregnant with Breast Cancer? Here’s How to Navigate Treatment

When breast cancer occurs during pregnancy, it presents a complex and challenging situation. Balancing early treatment of breast cancer while protecting the health of both the mother and the unborn child can be difficult. However, with advances in medicine and an experienced team of doctors, it is possible to navigate breast cancer treatment during pregnancy.

This article explores the key considerations for treating breast cancer during pregnancy.

What is pregnancy-associated breast cancer?

Pregnancy-associated breast cancer (PABC), or gestational breast cancer, is diagnosed during the first trimester of pregnancy or within the first year after giving birth.

There are two distinct types:

1. breast cancer diagnosed during pregnancy and
2. breast cancer diagnosed post-partum.

Emerging data suggest that outcomes for PABC may be worse for post-partum cases. It is essential to seek professional advice from your doctor on how this distinction may affect you. Read on to learn more about common questions and treatments for PABC.

Is breast cancer during pregnancy common?

Breast cancer occurs in approximately one in every 3,000 pregnancies (0.033%).

In Singapore, with over 38,000 live births annually, about 12-15 pregnant women are diagnosed with breast cancer each year. PABC is considered rare.

Thomson Breast Centre diagnoses about 50 patients with breast cancer annually, with 5-6 cases being pregnancy-related. This represents about 10% of our cases. The incidence of PABC is low but may be increasing as more women become pregnant later in life. Despite being uncommon, breast cancer is the most prevalent malignancy encountered during pregnancy and postpartum.

Who is at risk of pregnancy-associated breast cancer?

PABC risk factors include obesity and a significant family history of breast cancer. If more than two women in your family were diagnosed with breast cancer before age 50, you might be at higher risk.

To reduce your risk,

1. maintain a healthy weight,
2. start regular breast self-examinations from your teenage years
3. know your family history.

Identifying whether you're a high-risk patient can help determine treatment options early.

How to ensure early detection of breast cancer during pregnancy?

Several steps can help detect breast cancer during pregnancy.

1. Start with monthly breast self-examinations to become familiar with the texture and shape of your normal breast tissue.
2. If you find lumps, consult a breast doctor.
3. Understand how your body changes during pregnancy and seek medical advice if you notice any unusual changes. A radiation-free ultrasound scan may be recommended by your doctor.
4. Always rely on information from reputable sources like HealthHub, National Cancer Centre Singapore, and PubMed.

How is breast cancer diagnosed during pregnancy?

The initial diagnosis involves a needle biopsy to confirm the presence of breast cancer cells and determine the type. However, some scans are not performed during pregnancy to avoid potential radiation exposure.

Pregnancy-related changes in the breast can also complicate diagnosis. Therefore, it is crucial not to delay seeking medical advice if you suspect breast cancer.

Does pregnancy increase breast cancer risk?

Pregnancy does not trigger cancer. However, oestrogen exposure is a potential link.

Factors such as early menstruation, late menopause, or not having children are classic risks. Starting families later may also increase the risk. Abnormal cell changes before pregnancy can grow faster due to higher hormone levels during pregnancy.

Pregnant and non-pregnant patients with breast cancer have similar survival rates. Terminating pregnancy does not improve the prognosis for pregnant patients receiving standard treatment.

Can a pregnant woman receive breast cancer treatment?

Yes, pregnant women can receive treatment. Breast cancer surgery and chemotherapy are reasonably safe during pregnancy, depending on the type, stage, and trimester.

However, the treatment sequence may differ from that outside pregnancy. Discussions on fertility preservation, gene testing, breast-conserving surgery, and reconstruction may be necessary. Coordination between an experienced team of surgeons, oncologists, and gynaecologists is essential. Find a trustworthy team of doctors to guide you through this process.

Can you have a healthy pregnancy with breast cancer?

There is no evidence that a mother’s previous breast cancer negatively impacts her unborn baby. Infants exposed to chemotherapy in the womb generally have normal development and no significant health issues. Avoiding preterm delivery when possible is recommended for pregnant women with breast cancer. This indicates that a woman with breast cancer can have a healthy pregnancy.

Breast cancer treatment during pregnancy

We recommend speaking with our breast specialists for a comprehensive assessment and consultation on breast cancer treatment during pregnancy. With extensive knowledge and experience in this field, our specialists can guide you through the process and ensure you receive the best possible care. Schedule a consultation with Thomson Breast Centre.