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Home What is Breast Cancer Breast cancer and Pregnancy Doctor I am pregnant and now I have this lump...?

Doctor I am pregnant and now I have this lump...?

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Pregnancy and Breast Cancer

Introduction:

Developing breast cancer during pregnancy is a time of mixed emotions in a woman’s life. On one hand you have the joy of welcoming a new life and on other hand you are facing the uncertainty of having breast cancer. Here at the University of Illinois at Chicago a multidisciplinary team of Medical Oncologists, Radiation Oncologists, Surgical Oncologists and Maternal fetal specialist who utilize a combined treatment approach for our patients as well as their expected babies.

Our group has over 25 years of experience and is here to answer all your questions during this difficult time period.

1. How common is breast cancer during pregnancy?

Answer: Breast cancer during pregnancy is a relatively uncommon event. Breast cancer associated with pregnancy has a frequency of 1 in 3000 pregnancies (1) The diagnosis of breast cancer in pregnancy is often delayed because neither the patient nor the physician suspects cancer. The incidence of pregnancy-associated breast cancer is expected to increase as more women delay childbearing, a reflection of the increased incidence of breast cancer with advancing age.

2. Can I have a mammogram when I am pregnant?

Answer: Mammogram during pregnancy with shielding can be done safely and the accuracy can be reported to be greater than 80%(2). Ultrasound is another safe option that can be used to asses and stage breast cancer and also to assist with biopsy.

3. Can I have a biopsy when I am pregnant?

Answer: Biopsies can be safely done during pregnancy and is needed to establish a diagnosis of breast cancer.

4. Can I have surgery when I am pregnant?

Answer: Here at the University of Illinois at Chicago our Surgical Oncology team takes a case by case approach with extensive counseling of our patients to make the best individualized treatment option.  The options may include a modified radical mastectomy in which case radiation treatment is not needed after delivery or alternatively a breast conserving surgery if radiation therapy can delayed until after delivery(3). When surgery is decided during pregnancy we have our obstetrical and prenatal specialist present on site.

5. Can I have chemotherapy when I am pregnant?

Answer:  Our breast cancer oncology team led by Dr. Divyesh Mehta has over 25 years experience and he makes a treatment decision based on each individual patient and which trimester they are in . During the 1st trimester chemotherapy is contraindicated as this is the time when the fetus is at most risk. If chemotherapy needs to be given it can be given in the 2nd and 3rdtrimester (up to week 35). The decision of chemotherapy is not taken lightly by our medical oncology team, we have a extensive discussion with you and the potential risks that it may pose your baby.

6. Can I have radiation when I am pregnant?

Answer: Radiation cannot and should not be given during pregnancy. Our expert team here at the University of Illinois at Chicago will help you begin radiation therapy if needed after surgery.

7. I have heard about tamoxifen can I take that when I am pregnant?

Answer: Tamoxifen is NOT safe during pregnancy and should not be taken. Animal studies have shown that taking tamoxifen during pregnancy can cause harm to the fetus.

The University of Illinois at Chicago multidisciplinary oncology team understands there are many dilemmas that face young women during this difficult time period. Our goal is to make you as well informed as possible in regards to the decisions during this time period.

Abdur Shakir MD; Fellow in Hematology Oncology

References

(1)  Reis, L, Hankey, BF, Miller, BA et al. Cancer Statistics Review 1973-1988. Bethesda, MD, National Cancer Institute, NIH publication 91-2789, III.39, 1991.

(2)  Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy.Yang WT Dryden MJ, Gwyn K, Whitman GJ, Theriault R.Departments of Diagnostic Radiology and Breast Medical Oncology, University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 57, Houston, TX 77030, USA. wyang@di.mdacc.tmc.edu Radiology. 2006 Apr;239(1):52-60. Epub 2006 Feb 16

(3) Conservative surgery and chemotherapy for breast carcinoma during pregnancy.
Henry M Kuerer, Karin Gwyn, Frederick C Ames, Richard L Theriault
Surgery Jan 2002 (Vol. 131, Issue 1, Pages 108-10)