Pregnancy changes the body in countless ways. Breasts get fuller, more tender, and sometimes lumpy. So when something unusual shows up, it's easy to put it down to just another pregnancy change and not think twice about it.
Sometimes it's not a change in pregnancy, though. Sometimes it's cancer. Getting that news while pregnant is a lot to take in. The diagnosis on its own is hard. The pregnancy on top of it makes everything feel more complicated, more urgent, more frightening. But treatment does happen during pregnancy. Doctors plan it carefully, with both the mother and the baby in mind.
How it gets diagnosed
Don't wait after delivery to have it checked if there is something that doesn't feel right, like a lump, discharge from the nipple, or skin that is different in color or texture. Get it checked now. Usually, an ultrasound is the first option and is safe for pregnancy. If it appears suspicious, a biopsy can tell if it is cancer. A mammogram with adequate protection is sometimes recommended.
Can treatment happen during pregnancy?
Yes, it can.
What that looks like depends on how far along the pregnancy is, what stage the cancer is at, and the mother's overall health.
Surgery is generally safe during pregnancy. Depending on where the tumor sits and how large it is, the surgeon might go with breast-conserving surgery or a mastectomy.
Chemotherapy can be given in the second and third trimesters when it's needed. The first trimester is avoided because that's when the baby's organs are forming.
Radiation, hormone therapy, and most targeted therapies wait until after delivery because of the risk they carry for the baby's development.
Will the baby be okay?
It's usually the first question following the diagnosis. And it's just the right one to ask. Breast cancer does NOT pass to the baby. The mother and baby are monitored closely throughout the pregnancy. Many women undergo treatment during pregnancy and have a healthy baby at the end of the process.
The obstetrics and oncology teams collaborate to decide when to deliver, depending on how far the treatment has progressed and on fetal development.
What about breastfeeding?
This depends on the treatment involved. Women undergoing chemotherapy, hormone therapy, or targeted therapy are typically advised against breastfeeding, as these treatments may be excreted into breast milk. If surgery were the only treatment, breastfeeding might still be an option depending on the situation.
Talk to your doctor about it before the baby arrives so you don't have any surprises, and you can make plans.
Taking care of yourself
Pregnancy is a physically and emotionally grueling experience when you're being treated. Allowing others to assist does not mean that you lack strength. It's necessary. Regular meals, proper hydration, adequate sleep, and attendance at all prenatal and oncology appointments all make it easier. Breast cancer in pregnancy is a serious condition. It is also treatable. Many women go through it without their baby's health being affected. Don't dismiss anything that feels unusual or wrong with your breasts as “just pregnancy.” Get it checked. The sooner it's picked up, the better the chances of a good outcome are for both you and your baby.