Breast cancer during pregnancy need not harm baby

Breast cancer during pregnancy need not harm baby

In addition, the majority of women who become pregnant after having had treatment for breast cancer will go on to have healthy pregnancies and healthy babies. These reassurances have been given in new Patient Information guidance published by the RCOG.

Breast cancer is the most common cancer in women affecting around 50,000 women in the UK each year but it is rare in younger women. Treatment success rates in the UK are good and improving with five-year survival rates currently around 80% for the under 50s age group.

The guidance says that growing numbers of young women who have been treated for breast cancer are going on to have babies and also, on rare occasions, breast cancer is diagnosed during pregnancy. The new guidance provides information for women in these situations and health professionals. It says that for women who are diagnosed with breast cancer while being pregnant, treatment will usually begin straight away and be offered according to the type and extent of the cancer.

The various treatment options include:

- surgery to remove the lump or the affected breast, which can be carried out at any stage in pregnancy

- chemotherapy, but this is not given during the first 13 weeks of pregnancy as it may cause abnormalities in the baby, while anti-sickness and steroid treatments that control chemotherapy side effects are also safe for the baby

- radiotherapy is not usually offered as a treatment option until after the birth

- two commonly used drugs, tamoxifen and herceptin, often given after initial treatment to reduce the chance of the cancer recurring, are not recommended during pregnancy and will be delayed until after the birth.

Although natural changes in a women’s breasts can happen when pregnant or breastfeeding, the college advises women who notice a lump to see their GP urgently or an obstetrician, who should refer them to a specialist breast team. Women can be offered an ultrasound scan, which is safe in pregnancy and in cases where a mammogram is needed, the woman’s abdomen will be shielded to prevent the X-rays affecting their baby.

The new information also discusses how breast cancer treatment may affect fertility and says medical teams should take into account any plans for future pregnancies and offer chemotherapy drugs that are less likely to affect fertility.

Philippa Marsden, chair of the RCOG patient information committee said: “It is important to emphasise that breast cancer during pregnancy is rare, with 1.3–2.4 cases per 10,000 live births.

“Being diagnosed with breast cancer whilst pregnant can be extremely frightening. However, a specialist team including a consultant obstetrician, midwife and breast team will look after a woman throughout her pregnancy and ensure the best possible outcome for both mother and baby.”

Cath Broderick, chair of the RCOG women’s network added: “The diagnosis and treatment of breast cancer is improving all the time and we are now seeing more women than ever surviving the disease.  Being pregnant does not seem to affect how successful treatment is.”

By Adrian O'Dowd, 

On medica, Monday 10 November 2014

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