​Breast Cancer Associated with Pregnancy

What is Breast Cancer Associated with Pregnancy?

Breast cancer can occur at any time, including during pregnancy. It's the most common form of cancer in pregnancy, affecting approximately one in 3,000 women.

Pregnancy itself does not cause breast cancer, and breast cancer does not spread to the developing fetus.

Due to changing hormones during pregnancy, breast cancer is often found at a later stage in pregnant women.

Although breast cancer treatment during pregnancy is possible, it's more complex due to the possible effects to the developing baby.

Types of Breast Cancer Associated with Pregnancy

Any type of breast cancer can occur during pregnancy, including:

• Ductal carcinoma, ductal carcinoma in situ, invasive ductal carcinoma
• Lobular carcinoma, lobular carcinoma in situ, invasive lobular carcinoma
• Inflammatory breast cancer
• Paget's disease of the nipple

Who's at Risk?

Pregnancy is associated with a specific set of risks for breast cancer, including:

• Family history of breast cancer
• Family history of late menopause
• First menstruation (menarche) before age 12
• First pregnancy after age 30
• Previous pregnancies not followed by breastfeeding

Learn more about the High-Risk Breast Cancer Program at Magee.

Symptoms of Breast Cancer Associated with Pregnancy

Talk to your doctor if you notice any of the following symptoms:

• A change in the size or shape of the breast
• A dimpled, puckered, or "orange-peel" appearance in the skin
• A lump or thickening in or near the breast or under the arm
• A nipple that turns inward
• Fluid — other than breast milk — from the nipple, especially if bloody
• Red or swollen skin on the breast, nipple, or areola (the dark circle of skin around the nipple)

Testing for and Diagnosing Breast Cancer Associated with Pregnancy

Because excessive radiation exposure, maternal anesthesia, or other diagnostic or therapeutic approaches may harm a developing baby, you and your doctor will need to discuss risk factors and possible outcomes in detail.

Some procedures may not be appropriate during pregnancy.

Experts at the Magee-Womens Breast Cancer Program use a variety of tests and procedures to diagnose and screen for breast cancer, including:

Test	Description
Ultrasound (sonography)	A noninvasive test using high-frequency sound waves to produce real-time pictures of tumors.
Magnetic resonance imaging (MRI)	An imaging technique using a computer, a magnetic field, and radio waves to produce images of the body's soft tissues.
Mammogram with computer-aided detection (CAD)	An imaging procedure of the breast using low-energy x-rays to screen for or detect breast cancer and other abnormalities. A digital mammogram uses a phosphor plate, rather than film, to view mammography images. CAD is software that highlights tissue abnormalities in a mammogram.
3D mammogram (tomosynthesis)	An imaging tool using low-energy x-rays to create a 3D image of the breasts.
Minimally invasive breast biopsy	The use of a needle to extract a tissue sample from the breast to test for cancer cells.

Treating Breast Cancer Associated with Pregnancy

If you're diagnosed with breast cancer associated with pregnancy, treatment will depend upon many variables:

• Your physical and emotional health
• The stage of your pregnancy
• The health of your developing baby
• The results of your tests

Your doctors and other specialists at the Magee-Womens Breast Cancer Program will work with you to discuss risk factors, consider your options, and determine a course of action.

Treatment Options for Breast Cancer Associated with Pregnancy

Surgery is often the primary treatment for breast cancer.

In many cases, we may also recommend additional therapies before (neo adjuvant) or after (adjuvant) surgery to control an aggressive cancer or to reduce the risk of recurrence. We do not recommend radiation therapy for pregnant women, due to the potential harm to the fetus.

Procedures and treatments for breast cancer may include:

Surgical Procedures
Mastectomy	The surgical removal of part of the breast with a cancerous tumor (lumpectomy), breast tissue, or the entire breast. In some cases, lymph nodes are also removed. In rare cases, some of the chest muscles are removed as well.
Sentinel lymph node biopsy	A minimally invasive procedure to remove lymph node tissue in the armpit to check if existing breast cancer is spreading (metastasizing). Women diagnosed with an invasive breast cancer typically undergo a sentinel lymph node biopsy.
Axillary lymph node dissection	Surgery to remove all or a group of lymph nodes in the underarm (axilla), if your sentinel lymph node biopsy is positive for cancer.
Additional Breast Cancer Therapies
Chemotherapy	The administration of drugs to destroy the growth abilities of cancer cells. It is sometimes used with radiation therapy.
Hormone therapy	The use of drugs that stop the production of certain hormones that the cancer needs to grow.