Understanding breast cancer and pregnancy

It may feel unreal to be diagnosed with breast cancer while pregnant. But breast cancer is actually the most common cancer diagnosed during pregnancy. It affects about 1 in every 3,000 pregnant people. And many people with breast cancer can be treated while pregnant. Most research shows that treatment outcomes of both pregnant and non-pregnant people with breast cancer are similar.

There are some unique challenges with breast cancer and pregnancy. For example, some imaging tests and treatments may not be safe for your unborn baby. Your healthcare team will take extra safety steps and help coordinate your care. They will make sure you and your baby get the best care possible.

Breast cancer symptoms

It can be hard to find breast cancer during pregnancy. This is because pregnancy often causes changes in the breasts. Breasts may become larger, more dense, sore, or lumpy during pregnancy. But tell your healthcare provider about any unexpected changes to your breasts right away, including:

• Lumps

• Changes in shape

• Dimpling, puckering, or swelling

• Scaly or red skin

• Nipple turned inward

• Leaking of any fluid (other than breast milk) or blood from the nipple

Treatment choices during pregnancy

Your healthcare team will work with you to develop a treatment plan that considers your needs and the needs of your baby. Their goal is to get you to better health. They want to help you deliver a healthy baby, too.

It is normal to feel scared about being treated for cancer, especially while you’re pregnant. Your healthcare team members are there to guide you through this time. They will make sure you are safe. They will monitor your baby along with your obstetrician.

You probably have lots of questions. Make sure to ask them. Make sure you understand the benefits and risks of each treatment option. Getting answers will make you more comfortable about your treatment choices. Your treatment plan will depend on:

• The size and location of your tumor

• If the cancer has spread

• The stage of your pregnancy

• Your overall health and personal preferences

Your healthcare provider may talk about:

• Surgery. This is often the first step in treating breast cancer. Many people can have surgery while pregnant. Your surgeon may advise a lumpectomy. This depends on the size of your tumor and where it is. In this procedure, your tumor and a small amount of nearby tissue are removed. Another option is a mastectomy. This surgery removes your entire breast.

• Chemotherapy (chemo). This is generally safe in the second and third trimesters of pregnancy. Your healthcare team will carefully consider the risks and benefits of chemo for you and your baby. Some chemo medicines may be safer for the baby than others.

Targeted therapy, hormone therapy, and radiation therapy are usually not advised in pregnancy. They are more likely to cause harm to the baby. Your healthcare team may delay these treatments until after your baby is born.

When deciding on a treatment, ask your healthcare provider how it may affect these:

• Your ability to breastfeed

• Your ability to have more children in the future

Coping with emotional and physical challenges

You may feel a wide range of emotions. It's normal to feel fear, anxiety, sadness, or anger. You may have physical symptoms such as fatigue, nausea, and pain.

Try to focus on self-care as much as you can. Reach out for any support you need. This may include:

• Talking with a counselor who specializes in cancer and pregnancy

• Joining a support group or online forum for pregnant people with breast cancer

• Doing activities that bring you joy and relaxation, such as yoga, meditation, or art therapy

• Telling your healthcare team right away if you have any symptoms so they can help you manage them

Getting support

There are many resources to help you. Some of these include:

• Young Survival Coalition. This group provides help, education, and resources for people with breast cancer. This includes those who are pregnant or breastfeeding. Visit youngsurvival.org.

• National Cancer Institute’s Cancer Information Service. Use the institute’s free, confidential helpline. A specialist can give information and support to you and your family. Call 1-800-4-CANCER (1-800-422-6237).

• American Cancer Society. They give help, information, and resources for people with cancer, including those who are pregnant. Go to www.cancer.org.

When to call your healthcare providers

Your healthcare team will closely monitor you during your pregnancy and treatment. They want to help with all of your needs.

It’s important to tell your team about any changes in your symptoms. Ask how to contact your healthcare team outside of office hours. Tell your providers right away if you have any of these:

• New or worse breast pain or swelling

• New lumps or changes in the texture of your breast tissue

• Signs of infection, such as fever, chills, or redness and warmth around the breast

• Signs of preterm labor, such as contractions, vaginal bleeding, or pelvic pressure

Don't miss any regular prenatal appointments. Stick to your healthcare team’s advice for follow-up care after treatment. Ask loved ones to come to appointments with you. They can help you take notes and ask questions.