Pregnancy & Breast Cancer

Pregnancy-associated breast cancer demands a thorough and nuanced approach to treatment and care, considering both maternal and fetal health. Advances in diagnosis and treatment protocols offer hope for favorable outcomes, but close coordination among healthcare providers and personalized care plans are essential. 

The Weiser Family Center for Breast Cancer provides compassionate, cutting-edge care for young adults affected by breast cancer. We enhance lives through early detection, personalized treatment, and survivorship support, while advancing research, education, and advocacy. Our unwavering commitment is to make a meaningful difference, improving breast cancer outcomes for all. 

Delivery Planning 

Timing may be adjusted based on the cancer's progression and the pregnancy's stage. Whenever possible, full-term delivery is desired to ensure fetal health. In cases where the cancer is aggressive, inducing early delivery (after fetal lung maturity is confirmed) may be considered to expedite treatment that cannot be administered during pregnancy. 

Postpartum Considerations 

• Breastfeeding is generally contraindicated during chemotherapy, hormonal therapy, and some targeted therapies due to the risk of drug transfer to the baby. 

• Close Monitoring and vigilant follow-up is necessary postpartum for both mother and child to monitor for any potential treatment-related effects. 

• Prognosis depends on the stage at diagnosis, cancer subtype, and how well it responds to treatment.Treatment decisions need to carefully balance risks and benefits for both the mother and the fetus. 

• Mental Health:  Diagnosis and treatment during pregnancy can be emotionally and mentally taxing, necessitating robust support systems and possibly counseling. 

• Support Networks: Involvement of multidisciplinary teams including oncologists, obstetricians, pediatricians, and mental health professionals is crucial. 

If you've been diagnosed with breast cancer and would like an appointment, please call 734-647-8902.  Healthcare providers looking to refer a patient, please contact M-LINE: 800-962-3555. 

For those with questions, please contact our Cancer AnswerLine at 800-865-1125. 

Common symptoms of breast cancer include:

• breast lumps

• changes in breast size or shape

• skin changes

• nipple discharge. 

Risk factors associated with breast cancer & pregnancy include: 

• Age: With more women delaying childbirth until their 30s and 40s, the incidence of PABC is on the rise, as breast cancer risk increases with age. 

• Genetic Factors: Mutations in genes such as BRCA1 and BRCA2 increase the risk of breast cancer, irrespective of pregnancy. 

• Family History: A family history of breast or ovarian cancer can also be a risk factor. 

• Clinical Examination: Physical exams should be performed regularly during prenatal visits. 

• Ultrasound: Preferred initial imaging method due to its safety during pregnancy. 

• Mammogram: Can be performed with abdominal shielding to minimize fetal exposure to radiation. 

• Biopsy: A definitive diagnosis requires a biopsy. Techniques like core needle biopsy are commonly used and are considered safe during pregnancy. 

Challenges in Diagnosis 

• Physiological Changes: Hormonal changes and increased breast density during pregnancy can mask symptoms, potentially delaying diagnosis. 

• Concerns about Imaging: Fear of radiation exposure can lead to reluctance in performing necessary imaging tests. It is safe to perform breast imaging when needed during pregnancy with appropriate precautions. 

Treatment must be individualized to ensure the best possible outcomes for both mother and child:  

• Mastectomy: Often recommended as it can be performed safely during any trimester.  

• Lumpectomy: Can be an option, but it usually requires post-operative radiation, which is contraindicated during pregnancy.  

• Chemotherapy: Certain chemotherapy drugs are considered safe during the second and third trimesters but are avoided during the first trimester due to the risk of congenital abnormalities.  

• Radiation Therapy: Typically postponed until after delivery, as it poses significant risks to the fetus. 

• Hormonal Therapy: Usually deferred until after childbirth due to concerns about fetal exposure.

• Targeted Therapy: Agents like trastuzumab, used for HER2-positive breast cancer, are avoided during pregnancy because of potential risks to the fetus.