Breast Cancer Treatment In Pregnant Women: Is It Safe For The Foetus?

While breast cancer is rare in pregnant women, if detected, its treatment does not affect the foetus in any manner. The survival rate is also high, provided the cancer is diagnosed early.

Breast cancer is the detection of malignant cells in the tissues of the breasts. It is among the most common types of cancers worldwide. According to data published by the Indian Council for Medical Research (ICMR), breast cancer accounts for 28.2 per cent of all cancers in Indian women. It should, however, be noted that breast cancer during pregnancy is an extremely rare occurrence, affecting about 1 in 3,000 pregnancies, says Dr Anil Heroor, head of surgical oncology at Fortis Hospital Mulund, adding that it is commonly diagnosed in women between the ages of 32 and 38 years.

Breast Cancer Risk For Pregnant Women

Dr Heroor explains that for pregnant women, there are no specific risk factors for breast cancer. "Typically, a family history of breast cancer may increase an individual's risk of developing the disease at some point in their life. It is difficult to diagnose it during pregnancy, due to natural changes in breasts, as they become swollen and enlarged, filled with milk. A lump may be difficult to detect as it can be hidden within the breast tissue," the expert explains.

According to him, one thing that pregnant women can check for, is whether the affected breast appears to be larger than the unaffected one.

"Another issue with diagnosing breast cancer during pregnancy is that people generally do not expect it to happen, leading to delays in diagnosis," the doctor states.

Detecting Breast Cancer In Pregnant Women

The expert states that if breast cancer has been detected in a pregnant woman in an extremely rare case, proper treatment must begin immediately. Doctors usually opt for surgery to remove the cancerous lump, followed by chemotherapy to kill the cancer cells in the second trimester of the pregnancy. "The treatment has to be a collaborative effort between a multi-disciplinary team comprising a cancer surgeon, a medical oncologist and a paediatrician," he says.

The Treatment Process

The course of the treatment is usually determined by the patient's desire to continue with the pregnancy. For instance, if a woman is in the early stages of pregnancy and already has a complete family, she may choose to terminate the pregnancy.

If the cancer is suspected at a more advanced stage, or if the patient wishes to continue with the pregnancy, a biopsy is typically performed through a small incision. Once a diagnosis is established, counselling is provided, and treatment begins, Dr Heroor explains.

How Is The Foetus Protected?

The doctor says that due to the potential harm to the foetus, PET scans and X-rays are avoided; radiologic investigations are minimised. Ultrasound, however, is safe and commonly used for 'metastatic workups'. A CT scan of the chest can also be performed with appropriate precautions. Once the necessary evaluations are completed, breast cancer treatment follows standard protocols with drug dosages adjusted to ensure the safety for the foetus.

In Conclusion

Dr Heroor concludes by saying that the risk of breast cancer during pregnancy is higher than in non-pregnant individuals. "This is often due to its more aggressive nature and late diagnosis, resulting in poorer outcomes compared to cases diagnosed in women who are not pregnant. But, breast cancer and its treatment does not affect the foetus, and with advancements in treatment options, survival rates -- even in pregnant women -- are positive, especially when the cancer is detected in a timely manner."