Breast Cancer and Pregnancy

For most women, the thought of being diagnosed with breast cancer during pregnancy never crosses their mind.

However, with women delaying childbearing until their 30s and 40s, the incidence of breast cancer during pregnancy is increasing. We estimate 1 pregnancy in 3,000 is affected by breast cancer. Women must be aware of this and pay attention to breast changes that occur during their pregnancy.

Signs and symptoms

It is normal for the breast to change and enlarge even during early pregnancy. Symptoms to be concerned about include a lump or mass in the breast or under the armpit, a persistent rash on the breast, nipple discharge coming from only one side, or an inward nipple. Again, some of these changes may be associated with hormone fluctuations during pregnancy. Still, it's always advisable to bring them to the attention of your physician.

Diagnosing breast cancer during pregnancy

We can safely perform breast imaging during pregnancy. Typically, we use a breast ultrasound to evaluate an area of concern. If warranted, we perform a breast biopsy. We can also perform a mammogram with proper abdominal shielding during pregnancy.

Multidisciplinary treatment

In most cases, we can treat breast cancer while maintaining a pregnancy. Treatment options include surgery and chemotherapy, both of which can be considered in the 2nd and 3rd trimester of pregnancy. Several standard breast cancer chemotherapy drugs do not harm a fetus when administered during the 2nd or 3rd trimester. Therapies that we can’t give during pregnancy, such as radiation, HER2-directed therapies and endocrine therapy, we administer after delivery of the baby.

Pregnancy is stressful, as mothers-to-be worry over how to protect their unborn babies. Facing breast cancer and making challenging decisions on the best treatment options for both mother and baby raises stress to an unimaginable level. Women who face breast cancer during pregnancy should seek multidisciplinary care at a National Cancer Institute-designated cancer center, such as The University of Kansas Cancer Center. Our highly specialized care requires – at minimum – the orchestration of a breast medical oncologist, breast surgical oncologist, breast radiologist, perinatologist and their obstetrician.

If you are diagnosed with breast cancer during pregnancy, do not rush to terminate your pregnancy. Seek a second opinion at an NCI-designated cancer center to learn about the options available to you and your unborn child.