While you are counting the days to become a mother, you learn that you have breast cancer! It sounds scary, but General Surgery Specialist Assoc. Dr. Mehmet Eser gave heartwarming information: “Breast cancer surgeries on pregnant women can be performed at any stage of pregnancy. Patients who will not receive chemotherapy, radiotherapy and endocrine therapy after surgery can breastfeed their children.”
Breast cancer is the nightmare of every woman in the world... It ranks second in female deaths due to cancer. One in eight women may experience breast cancer at some point in her life. Although breast cancer is more common after the age of 50, it is also seen in a significant number of patients in their 30s and 40s. The rate of breast cancer in women who have not given birth or who have given birth after the age of 35 is up to 1.7 times higher than in those who have given birth. General Surgery Specialist Assoc. Dr. Mehmet Eser said that the possibility of encountering cancer while pregnant increases due to the general increase in breast cancer and women becoming mothers later, and gave important information.
It is difficult to accept, but be strong
Approximately 1 million 300 thousand births occur annually in Turkey. The incidence of breast cancer during pregnancy, which varies between countries and societies, is on average one in 10 thousand births. Considering all breast cancers, there is a good chance that very few women will be diagnosed with breast cancer while pregnant. However, receiving such a diagnosis at a young age, especially on the eve of a happy event such as having a baby, is a situation that is very difficult to accept for both the patient and their relatives, and has a psychologically devastating effect. Correct guidance and correct treatment planning are very important, especially for the protection of the baby.
Unfortunately, diagnosis may be delayed
Due to the young age and radiation in pregnant patients. Not having screening mammograms and the small size of the mass take away our chances of detecting cancer. Changes during pregnancy, such as breast enlargement and increased tissue density, make it difficult to detect a mass. This usually causes the cancer to be detected in a larger mass and therefore at a more advanced stage. Also It is very difficult to distinguish cancer-related masses in pregnant women and lactating women by examination and ultrasonography, from galactocele, which is colloquially called 'milk knot', where the milk in the breast is difficult to empty and takes the form of a milk-filled cystic mass, and benign tumors in breastfeeding women, by examination and ultrasonography.
You do not have to give up your baby
The first thing that comes to mind for diagnosed pregnant patients and their relatives is the concern that the presence of the baby is an obstacle to treatment. With this belief, many families may want to abort the baby. Nowadays, no matter at what stage of pregnancy the diagnosis is made, breast cancer treatment can be done quite successfully without taking the baby, by changing the type of surgery to be performed on the breast according to the period of pregnancy, the selection of chemical treatment drugs to be given and the timing of radiotherapy. It is possible to perform breast cancer surgery on pregnant patients at any stage of pregnancy. Chemotherapy drugs can be given to patients who are diagnosed at an advanced stage or who require chemical treatment in preparation for breast-conserving surgery, after the 4th month of pregnancy, and the surgery can even be postponed until after birth. However, not all chemotherapy drugs can be used during pregnancy. Treatment can be performed by selecting chemotherapy agents that can be used during pregnancy. Of course, there are some risks. However, it is at acceptable rates.
It is no different from those who are not pregnant.
Abortion of the child is only recommended for those who are diagnosed at a very advanced stage, who have additional diseases that cannot tolerate the side effects of chemotherapy, and who have tumors during pregnancy. It may be required in rare cases where it has biological properties that require endocrine therapy that is undesirable to administer. If a person who has breast cancer while pregnant will not receive chemotherapy, radiotherapy or endocrine treatment after giving birth and has milk secretion, she can breastfeed. However, since most patients continue postpartum treatments, most commonly radiotherapy, breastfeeding is not possible. In short, the treatment of pregnant patients should be discussed and decided in breast councils where breast surgeons, medical oncologists, radiologists, radiation oncologists, psychologists and pathologists are present. With the treatment methods used today, it is possible to obtain the same results as non-pregnant patients at the same stage, while protecting the baby.
They can have mammography
The diagnostic tool for pregnant patients is primarily ultrasonography, as it does not give radiation. However, when necessary, mammography can be performed safely by protecting the abdominal area with lead-containing aprons. In this case, the dose the baby will receive is extremely low and within safe limits. Gadolinium, which is used as standard in breast MRI, cannot be used in pregnant women. Therefore, MRI can only be performed during pregnancy without giving contrast material (without medication) if necessary. Pregnant women can receive chemotherapy after the first trimester. Studies show that babies of mothers receiving chemotherapy are also healthy.
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