Breast cancer while pregnancy and breastfeeding part I.

Breast cancer while pregnancy

Breast cancer remains the most common cancer in women. Can you get it during pregnancy or while breastfeeding? How to recognize and treat it?

 

The average global incidence of breast cancer in pregnancy, according to a study published in the European Journal of Surgical Oncology in 2008, is about 1 in 3000 cases. Although at first glance these numbers do not seem high, breast cancer is the second most common cancer in pregnant women. With more and more women choosing to become pregnant later in life, breast cancer is becoming more common in pregnancy, as the incidence of breast cancer also increases with age.


How is breast cancer diagnosed during pregnancy?


During pregnancy, the structure and size of the breasts change – each breast gains about 200g in weight. The breasts not only become larger, but also their structure changes – they become more compact. Unfortunately, this means that “an extra lump” occurring in them may be downplayed by women., This leads to breast cancers detected during pregnancy being at a more advanced stage of development – they are larger, better vascularized and often already have spread to other parts of the body (metastasized).

 

Symptoms of breast cancer in pregnancy

 

Breast cancer during pregnancy most often manifests as a non-painful thickening or lump, which is sometimes accompanied by a nipple discharge. Leakage of fluid from the nipple during pregnancy can also be a natural occurrence, which makes it difficult for a woman to catch this symptom. Palpation or mammography during pregnancy is also more complicated because of the aforementioned change in breast structure. In addition, mammography poses a risk to the developing fetus as it is a diagnostic technique that uses ionizing radiation (learn more about mammography).

 

Breast examination during pregnancy

 

The current standard for breast cancer screening in pregnant women is clinical breast examination (palpation – or touching – by a physician). Any breast changes felt on palpation should be further evaluated by a specialist who uses methods such as breast ultrasound or biopsy. Ultrasound is a safe and non-invasive method, but it happens to be inconclusive. Biopsy, on the other hand, poses a risk of milk fistula developing at the puncture site, infection and bleeding. However, it is still the technique of choice for the final evaluation of a suspicious change. The use of MRI (magnetic resonance imaging) to examine the breasts in pregnancy is a method that gives very good results however it should not be used in early pregnancy and approached with caution in later stages. Hence, the use of an appropriate diagnostic procedure is a compromise between the risk it poses for the mother and the child, and its usefulness in the process of diagnosis, which may, after all, save lives.

 

Breast cancer during breastfeeding

 

Breastfeeding has a protective effect on the occurrence of breast cancer throughout our lives. Nonetheless, breast cancer can occur even during this particular period. Just like during pregnancy, the structure of the breast is changed and it is easier to overlook worrying symptoms.  In addition, a lump in the breast can also be caused by a blocked milk duct or infection. The diagnostic challenges a doctor faces are comparable to those during pregnancy.  Ultrasound is the method of choice, and suspicious changes can be biopsied. Mammography is not impossible, but the results are difficult to interpret.

 

What breast cancer treatments are possible during pregnancy and nursing? We will discuss this in the second part of this post.

 

 

References

 

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