Being diagnosed with breast cancer is a frightening and life-altering experience for most women. When a pregnant woman receives this bad news, however, the diagnosis may cause even more emotional turmoil and medical complications. The following treatment options may be considered, but are dependent on the stage of the cancer and the stage of the pregnancy.
Surgery
Surgery is often the first method of treatment for a pregnant woman with breast cancer. There are various forms of surgery which aim to remove the cancer from a woman's breast:
-A total (or simple) mastectomy removes the entire affected breast and, likely, some lymph nodes beneath the arm.
-A partial mastectomy removes the part of the breast that contains cancer, some normal surrounding tissue, and, often, some lymph nodes under the arm.
-A lumpectomy removes the tumor, a small amount of normal tissue that surrounds it, and typically also some lymph nodes beneath the arm.
These surgeries pose little risk to the fetus, but there are times in a pregnancy when the required anesthesia could be more damaging. The supervising physicians will work together to determine the best time to operate.
Radiation Treatment
Women who undergo a lumpectomy (conserving some of the breast) rather than a total mastectomy may end up needing radiation treatment to prevent cancer from returning. Pregnant women should be concerned about receiving high doses of radiation because, according to Cancer.org, radiation could harm the fetus or cause miscarriage at any time during pregnancy. Therefore, radiation treatment is not recommended for women who are pregnant. A woman may opt to wait until after birth to receive radiation, but the cancer may return.
Chemotherapy
Chemotherapy ("chemo") is an additional form of breast cancer treatment which uses drugs to stop cancer cells from growing, either by killing them or stopping them from dividing. It is usually offered after surgery to women with breast cancer in earlier stages. It may also be used alone for cancer in more advanced stages. Women who are in their first trimester (initial three months of pregnancy) do not typically receive chemotherapy. This is because the first trimester is the most vulnerable stage of pregnancy, when many of the fetus's internal organs are developing and the risk of miscarriage is highest. Chemotherapy given in the second and third trimesters is not known to harm the fetus, but can cause pre-term labor and low birth weight.
Hormone Therapy
Hormone therapy treatments, such as tamoxifen, may be used after breast cancer surgery or as treatment for advanced stages of cancer. However, its use in pregnant women has not been well-researched. According to Cancer.org, most infants born to women taking tamoxifen have been born normal. However, cranial and facial birth defects have been reported in cases where women became pregnant while they took tamoxifen. Until more research is conducted, breast cancer hormone therapy is not recommended for pregnant women.
Termination of Pregnancy
Sometimes a woman is advised to end a pregnancy if the breast cancer would best be treated with chemotherapy and radiation therapy. This may be a decision that depends on the woman's chance of survival, how advanced the cancer is, and the age of the fetus.
Tags: breast cancer, lymph nodes, pregnant woman, some lymph, some lymph nodes, with breast
