Hormone level changes throughout a woman's life lead to changes in the breasts. That being said, hormone level changes during pregnancy fortunately do not largely translate into breast cancer. In fact, according to the American Cancer Society only a few pregnant women are diagnosed with breast cancer each year--approximately 1 out of every 3,000. Many factors can affect the diagnosis of breast cancer during pregnancy, and many variables can influence treatment options.
Diagnostic Challenges
Breast cancer in a pregnant woman is often diagnosed at a later stage than a woman who is not pregnant, according to the American Cancer Society. Pregnancy-related hormones become elevated during this time, which causes the breasts to become lumpy, larger, and tender, making self-detection more difficult. Breast tissue becomes denser, making mammograms harder to read. Many women become concerned about radiation exposure from a mammogram during pregnancy. While many doctors prefer to not perform mammograms during pregnancy, the amount of radiation required for the test prove relatively small, and a lead shield is placed over the belly to protect the fetus as an extra safety measure.
Exposure During Exploration
Once a pregnant woman has had a mammogram, many doctors will continue with further tests to confirm a breast cancer diagnosis. These tests can include an MRI scan, a chest X-ray, as well as a bone scan or computed tomography (CT) scan of the chest, abdomen, or pelvis. The American Cancer Society says that the only potential risk to the fetus results from the MRI contrast material or die, which can cross the placenta. MRI contrast material has a link with fetal abnormalities in lab animals. For this reason, physicians recommend an MRI that does not use contract dye during pregnancy. Chest X-rays prove another treatment option because of the small amount of radiation used in chest X-rays is considered safe for pregnant women provided the lead shield covers her abdomen and protects the fetus. If doctors suspect that the cancer has spread, a CT or bone scan test may become necessary. Test adjustments can minimize the amount of fetal radiation exposure.
Treatment During Pregnancy
The type and timing of breast cancer treatment depends on many factors, including the size and location of the tumor, and the stage of pregnancy. Surgical options can range from the removal of the tumor known as a lumpectomy to removing the entire breast, or a mastectomy. In surgical cases, the surgeon, anesthesiologist and obstetrician will work to determine the ideal time during the pregnancy to perform the surgery and administer anesthesia to minimize anesthesia exposure to the fetus. In the case of radiation therapy, most doctors prefer to wait until after the birth to avoid exposing the fetus to large amounts of radiation. Doctors usually avoid administering chemotherapy therapy treatments during the first trimester, according to the American Cancer Society, to minimize internal organ development damage. During the second and third trimesters, a select number of chemotherapy drugs prove useful to not raise the risk for birth defects or stillbirths. Chemotherapy is not recommended for the month prior to delivery as it has an adverse effect on maternal blood cell counts that can cause bleeding during delivery and lead to infection.
