Breast
Cancer and Pregnancy
By Will Hanke
Although it is rare for breast cancer to strike younger women,
the fact remains that all women are at risk. And for those of
childbearing age, the first sign and symptoms of breast cancer
leading to a diagnosis can not only be upsetting and unexpected,
but complicated as well.
Developing breast cancer
at a younger age—in a woman’s 40s, 30s, even 20s—will
mean making important and difficult decisions about one’s
life and future perhaps much sooner than originally expected.
One concern is developing
breast cancer during pregnancy, which although rare, can still
occur. In this case, the treatment chosen will not only affect
the patient and her body, but the growing baby inside her as well.
It will depend on what stage of pregnancy she is in (first, second
or third trimester) and what stage her cancer is in—such
as whether or not it’s advanced.
Most pregnant
women can have treatment for their breast cancer without affecting
the baby. But some might be advised by their obstetrician or health-care
practitioner—or even decide themselves—to terminate
the pregnancy, more so if the pregnancy is in its earlier stages,
in order to receive certain treatments that would be too risky
otherwise. But it is essential to remember that it is a woman’s
own decision—it is not medically necessary to terminate
a pregnancy if the expectant mother is diagnosed with breast cancer.
All it does is limit treatment options. Breast cancer itself will
not affect the fetus—only certain tests and treatments will.
Generally speaking,
tamoxifen, chemotherapy, radiation, and other drug-related therapies
are avoided if the woman is pregnant because of their associated
risks with birth defects. Tamoxifen, especially, is considered
very unsafe because it is a hormonal therapy and is never recommended
if the woman is pregnant or planning on conceiving.
Surgery—either
a lumpectomy or mastectomy—is the most common and preferred
method of treatment for breast cancer in pregnant women.
Another concern is
whether or not breast cancer survivors can or should go on to
have children after treatment and recovery. It’s a very
controversial issue with firm advocates on both sides of the debate.
There are two main
questions here, for both the medical and health community and
breast cancer survivors wanting their own children: 1) Do certain
breast cancer treatments affect fertility?; and 2) Is it actually
considered safe to conceive and carry a baby to term following
breast cancer and breast cancer treatments?
As far as fertility
goes, there is no definite answer here. For chemotherapy, it depends
on the age and what specific drug was used—some affect fertility
more than others. And taking tamoxifen after chemotherapy to prevent
recurrence is not recommended if the woman desires to become pregnant
right away. Although tamoxifen is sometimes used as a fertility
treatment, there is evidence to suggest that it damages developing
embryos, and therefore is not considered safe to use.
Many doctors caution
these women to wait several years to ensure receiving the best
breast cancer treatment possible and to go past the point of the
biggest threat of breast cancer recurrence. But some women decide
to go ahead and have babies anyway, since it’s so important
to them.
An informed woman has
a distinct advantage over her fears. Arm yourself about Breast
Cancer and be ready to fight and beat any possible diagnosis.
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