When pregnant women are threatened with breast cancer, whether they need to stop pregnancy is probably the toughest issue for them. As whether to terminate pregnancy depends on pregnancy stages, there's no conflict between the fertility of pregnant women diagnosed with breast cancer and survival.
For the patients during the first 3 months of pregnancy diagnosed with breast cancer, generally doctors will recommend that they end the pregnancy. If breast cancer patients insist on continuing with the pregnancy, mastectomy and axillary lymph node dissection are to be required. Then adjuvant chemotherapy is to be used during the second trimester of pregnancy. After childbirth, the breast cancer patients will have radiation therapy and endocrine therapy.
If breast cancer is found in the mid-late pregnancy, the sequencing of surgery and chemotherapy should be based on tumor size. If breast-conserving surgery is used, radiotherapy will be performed after delivery. Endocrine therapy and targeted therapy can also be carried out after childbirth.
For those diagnosed with breast cancer in the last 1 month of pregnancy, they can go through various breast cancer treatments after delivery.
In order to protect babies, the traditional treatment for breast cancer during pregnancy has some limitation rules. For example, endocrine therapy and radiation therapy cannot be used throughout the pregnancy, and chemotherapy can only be used after the first trimester of pregnancy. But the effects of targeted therapy on the fetus have not yet been clear. There is no difference in the dose intensity in between chemotherapy for breast cancer during pregnancy and conventional chemotherapy. Extensive studies have shown that mothers who'd received chemotherapy in the second trimester delivered healthy babies, and after they're grown up, the incidence of disease and cancer has not increased, but the longer-term impact is still unknown.
Breast lumps during pregnancy and lactation must never be neglected
Because it is now impossible to undergo genetic testing for breast cancer during pregnancy or breast-feeding till now, it's unable to determine individuals at high risk for breast cancer. However, all breast lumps during pregnancy and lactation should be taken seriously.
Breast lumps during pregnancy have been seen as hyperplasia for long, which is often neglected. When a lump is hard, the hardness is increasing and even nipple bleeding occurs, you should be alert to the occurrence of breast cancer. In addition, mastitis in breast-feeding women can cause lumps. If the mass does not disappear after breastfeeding and even tends to be larger, further checks are to be required.
Women during pregnancy and breastfeeding should raise self care and self awareness, be more concerned about breast health, and perform a breast self-exam regularly. Once there's something wrong, they'd better consult a specialist instead of rely on the experience of those who've had similar problems. As some non-specialists would say that patients have hyperplasia or mastitis even without asking or checking them, breast cancer during pregnancy is easy to be misdiagnosed and thus the disease would be never be cured. Smart breast cancer patients will go to a specialist while some breast cancer patients' treatment may be delayed or missed due to misdiagnosis.
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