Obstetricians should perform a thorough breast examination of pregnant women to detect breast cancer, according to a recent study. Often, the diagnosis is delayed because doctors and pregnant women assume that lumps in the breast are due to normal hormonal changes. The threat of breast cancer is frightening for anyone, particularly during pregnancy, but it is not uncommon. Around one in every thousand women gets breast cancer every year. Pregnant women and physicians should be more aware of the risk of cancer. Speaking at the European Society for Medical Oncology conference, Dr Blanca Hernando from the University Hospital Clinic in Spain said, "The obstetrician is usually more focused on the health of the unborn baby than the mother's possible illness but should be more aware of the risk of breast cancer." Women should examine their breasts regularly and tell their doctor about any changes they discover.
Not only is diagnosis often delayed, but there is a high rate of false-negative results of a mammography due to the increased density of the breast during pregnancy.
Ultrasonogaphy is the best way to check for cancerous lumps in pregnant and lactating women. Many studies have shown that the tumours in pregnant women are larger and are more likely to spread.
Pregnant women should be encouraged to know that treatment is as successful and safe as in non-pregnant women. Surgery is the best route although there is a small risk of premature labour. Radiation therapy is not offered during pregnancy but patients can be safely treated with certain forms of chemotherapy from three months onwards. This may be continued after the baby is born, although mothers should not breast feed their babies while they are having chemotherapy.
In a study of 18 women with breast cancer, Dr Hernando reported that there was a 10- week delay in the diagnosis meaning that patients were treated when their cancer had progressed. All the patients had surgery to remove the lump and chemotherapy. Four women diagnosed in the first three months chose to have an abortion and another four patients needed a caesarean. All the babies born were healthy.
"Breast cancer during pregnancy has about the same prognosis as other breast cancer, when compared to women of a similar age," said Dr Hernando. "It is, of course, a very serious illness but it can be treated successfully. The most important thing is to be diagnosed and treated at an early stage to prevent it spreading to other parts of the body."
