Pregnancy-Related Breast Cancer: Options, Safety, and Further Information
In the complex world of cancer treatment, navigating breast cancer during pregnancy presents unique challenges. The National Comprehensive Cancer Network (NCCN) offers guidance on this matter, tailoring treatment to the gestational age to minimize risks for both mother and baby.
During the first trimester, surgery — such as mastectomy or lumpectomy — is the primary treatment option. Chemotherapy and radiation therapy are contraindicated due to potential risks to the fetus. In the second trimester, certain chemotherapy regimens, particularly anthracycline-based chemotherapy, may be considered relatively safe. Surgery remains the mainstay treatment, but the risk of teratogenicity decreases significantly after the first trimester, making chemotherapy a potential option.
As the pregnancy progresses into the third trimester, chemotherapy can be continued cautiously if necessary. Surgical options remain available, and radiation therapy should still be avoided until after delivery.
Doctors can generally perform surgery for breast cancer on pregnant individuals, although anesthesia may carry a higher risk for the baby at certain times during pregnancy. If chemotherapy is required after breast surgery, it is usually delayed until the second trimester. In cases where breast cancer is diagnosed during the third trimester, chemotherapy may be delayed until after the end of pregnancy, with doctors sometimes opting for early labor induction to begin treatment sooner.
Breast cancer during pregnancy is relatively rare, occurring in about 1 in every 3,000 pregnancies. However, it is crucial for any lumps found during pregnancy to be checked by a health professional, as they could be the beginnings of cancer.
The NCCN guidelines offer safe treatment options for both parent and baby according to the stage of pregnancy. Mastectomy with lymph node biopsy is recommended in the first trimester, as radiation is not safe for the fetus. Chemotherapy is not recommended during the first trimester of pregnancy.
Doctors avoid radiation therapy during pregnancy due to potential risks to the unborn baby. Studies have found that using certain chemotherapy drugs during months 4-9 of a pregnancy does not increase the risk of health problems shortly after birth. Breast biopsies are generally considered safe for a fetus.
MRI scans during pregnancy may not be safe due to the potential risks of the dye used during many MRIs on the unborn baby. Ultrasound exams, on the other hand, are safe for doctors to perform on pregnant individuals. Mammograms during pregnancy are generally safe, with doctors or assistants placing a lead shield over the belly for extra protection.
It is essential to note that breast cancer during pregnancy responds well to treatment in many cases. Many pregnant individuals who receive a diagnosis of breast cancer respond to treatment just as well as non-pregnant individuals of the same age with the same stage of cancer.
The NCCN guidelines are free to access, but require registering an account. It is always advisable to consult the official NCCN clinical practice guidelines on breast cancer and pregnancy for the most current information.
In conclusion, breast cancer during pregnancy is a complex issue that requires careful consideration and a tailored treatment approach. With the guidance of the NCCN and a dedicated healthcare team, pregnant individuals can receive the necessary care to effectively treat breast cancer while minimizing risks to their unborn child.
- In the first trimester, mastectomy or lumpectomy is the primary treatment for breast cancer in pregnancy, with chemotherapy and radiation therapy contraindicated due to potential risks to the fetus.
- As the pregnancy progresses into the second trimester, certain chemotherapy regimens may be considered relatively safe, but the risk of teratogenicity decreases significantly after the first trimester.
- In the third trimester, chemotherapy can be continued cautiously if necessary, but radiation therapy should still be avoided until after delivery.
- Doctors can perform surgery for breast cancer on pregnant individuals, although anesthesia may carry a higher risk for the baby at certain times during pregnancy.
- Breast cancer in pregnancy is relatively rare, occurring in about 1 in every 3,000 pregnancies, but any lumps found during pregnancy should be checked by a health professional.
- The NCCN guidelines offer safe treatment options for both parent and baby according to the stage of pregnancy, with mastectomy with lymph node biopsy recommended in the first trimester.
- Doctors avoid radiation therapy during pregnancy due to potential risks to the unborn baby, while breast biopsies are generally considered safe for a fetus.
- MRI scans during pregnancy may not be safe due to the potential risks of the dye used during many MRIs on the unborn baby, but ultrasound exams and mammograms are safe for doctors to perform on pregnant individuals.
- Many pregnant individuals who receive a diagnosis of breast cancer respond to treatment just as well as non-pregnant individuals of the same age with the same stage of cancer, and it is essential to note that breast cancer during pregnancy can be treated effectively with a tailored approach and the guidance of the NCCN and a dedicated healthcare team.
