Breast Cancer in Pregnancy | Gina's Story
How to Treat Breast Cancer During Pregnancy
About 1 percent of women out of 3,000 are diagnosed with breast cancer during their pregnancy. Often, breast cancer is diagnosed in pregnant women during a breast exam by their doctor as well as a biopsy of the lump to confirm it is cancerous.Breast cancer can be treated in pregnant women effectively, especially if it is detected early. If you are pregnant and have breast cancer, you can treat the issue using breast-conserving surgery as well as chemotherapy and radiation therapy. Your doctor may also recommend the use of hormone therapy and targeted therapy to treat the cancer, but only after you have given birth.
Using Breast-Conserving Surgery
Discuss the procedure with your doctor.Once you are diagnosed with breast cancer while pregnant, treatment will depend on the size of the tumor, where it is located, the stage of the cancer, and how far along your pregnancy is. Your doctor may recommend breast-conserving surgery (BCS) if your cancer is in the early stages or if it is at risk of spreading to other parts of your body. Surgery is often the first choice for breast cancer treatment during pregnancy as it is the safest option for your health and that of your unborn baby.
- For example, you may ask your doctor, "Would BCS be right for me and my stage of cancer?" "What will be involved in the procedure?" "What are the risks, if any, of the procedure?"
- Your doctor will tell you where the surgery will be done on your breast or breasts, depending on where the tumor is located. Often, the surgery is done in the breast and near your lymph nodes to remove any cancerous cells.
- Your doctor may also suggest removing your entire breast, known as a mastectomy, if the cancer is at risk of spreading to other parts of your body. This may a good option as you will not need to undergo radiation therapy after a mastectomy.
Address the use of anesthesia with your doctor.If you decide to do BCS, you will need to be put under with anesthesia, which are drugs that will make you sleep during the surgery. Using anesthesia can be risky for your unborn baby, so you and your doctor should talk about this aspect of the surgery beforehand. Meet with your obstetrician, a surgeon, and an anesthesiologist to determine the best time to do the surgery so the fetus is not at risk.
- For example, you may say to your doctor, "What risks does anesthesia pose to me and my unborn baby?" "Is it safe for me to go under anesthesia during the procedure?"
- Often, having the surgery earlier in your pregnancy is safer than doing it later on in your pregnancy.
- Your obstetrician may also be on call or present during the surgery in the event there are issues with the baby.
Do additional treatments after surgery.Once the BCS is done, you will need to follow a recovery plan to ensure you heal properly after the surgery. Depending on the stage of your breast cancer, you may also need more treatment, such as chemotherapy, radiation, or hormone therapy. This type of treatment is called adjuvant treatment. Doing adjuvant treatment after surgery will help to lower the risk of the cancer returning.
- In some cases, you can delay adjuvant treatment until after you have your baby. Speak to your doctor about this option.
Conduct your own research on BCS.Do your own research to determine if breast-conserving surgery is right for your stage of breast cancer. Speak to several different doctors and specialists so you are well informed. Read information online from trusted medical sources so you are well aware of the risks of the procedure and are sure it is right for you and your baby.
- Set up consultations with several different doctors and cancer specialists to discuss BCS as well as any other treatment options you may have. Getting several medical opinions could help you determine if BCS is safe and right for you.
Doing Chemotherapy and Radiation Therapy
Speak to your doctor about chemotherapy.Chemotherapy is often recommended for pregnant women who are in their second or third trimester. It is also good option if you have more advanced stages of cancer while pregnant. Chemotherapy can be given via intravenous and will be a mixture of several cancer fighting drugs.
- Your doctor may also recommend chemotherapy if your have had breast-conserving surgery and they want to be sure your cancer does not return.
- You can get chemo in your third trimester or after you have given birth without putting your baby at risk. This type of chemotherapy depends on the cancer's specific pathology and responsiveness to hormones, so it's important that you get an accurate diagnosis as soon as possible.
Discuss the risks of chemotherapy with your doctor.Before you agree to chemotherapy, make sure you are aware of the risks of the treatment by speaking in depth with your doctor. Chemotherapy is not given during the first trimester, or first three months of pregnancy, as it can put your baby at risk of health issues and increases your risk of a miscarriage. It is also not recommended within three weeks of your delivery date as it can lower your blood counts to dangerous levels, putting your baby at risk.
- Using certain chemo drugs during your last four to nine months of pregnancy does not raise your risk of birth defects, stillbirths, or health issues. Some women may be at a higher risk of early delivery if they have chemo in their third trimester of pregnancy.
Avoid radiation therapy.Radiation therapy on your breast or breasts while pregnant is not recommended, as it can harm your baby and increase your risk of miscarriage, birth defects, and childhood cancer in your baby. Chemotherapy is considered a safer option than radiation for breast cancer treatment while pregnant.
- You can get radiation therapy after your baby is born. Doctors recommend starting radiation right after giving birth so you have a lower chance of the your cancer coming back.
Lean on family and friends for support.Going through chemotherapy and radiation therapy can be a major challenge. To help you cope emotionally, try leaning on a support network of family and friends. If you have a partner, you may also rely on them for support and comfort as you battle the cancer.
- You can also try doing different techniques to help cope with stress. You may do gentle yoga stretches that are safe to do while pregnant or do self-care where you take a bath at home or do an activity you find relaxing like reading, writing, or painting.
- Another option is to join a support group for pregnant women who have breast cancer. Ask your doctor for a referral to a support group so you can connect to others who are experiencing many of the same feelings as you are.
Using Hormone Therapy and Targeted Therapy
Get hormone therapy once you have given birth.Hormone therapy is often used to treat advanced breast cancer in women with hormone receptor positive breast cancer. But it can put your baby at risk and should only be used after you have given birth. Hormone therapy requires the use of drugs like tamoxifen, anastrozole, letrozole, and exemestane.
- Speak to your doctor about this option for right after you give birth to treat the cancer. Your doctor may recommend that you get hormone therapy after you have had breast-conserving surgery and you have given birth.
Discuss targeted therapy with your doctor for after you give birth.Women who have hormone receptor positive breast cancer can benefit from the use of targeted therapy, where specific drugs are given to treat this type of breast cancer. However, it has been shown that these drugs are currently not safe for use by pregnant women as they can negatively affect the fetus. Speak to your doctor about using this therapy right after you have given birth so you can still get treated for your breast cancer effectively.
- If you get breast-conserving surgery, your doctor may recommend doing targeted therapy once you have given birth.
Focus on your health and the health of your baby.As you try different treatments for your breast cancer, try to stay focused on what is best health wise for you and your baby. Remain healthy while pregnant so your baby has the best chance of being unaffected by the breast cancer. Eat healthy while pregnant and get enough rest. Release any stress or tension you may be feeling by leaning on a support group of family and friends.
- You can also work on cultivating positive thoughts so you can have a positive outlook on your situation.
Video: Breast Cancer Discovered During Pregnancy
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