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Concerns About Breast Cancer During Pregnancy
If you are pregnant you may be worried about breast cancer and how it will affect your health and the health of your baby. You may have discovered some lumps or you may have discovered a discharge seeping out of your nipples. Most of the time these occurrences happen due to hormonal changes going on in the body at the time of pregnancy.
The fact is that most lumps and discharges from nipples that were first discovered during pregnancy are not cancer. On the other hand, breast cancer is more often diagnosed in pregnant women as compared to non-pregnant women. Breast cancer afflicts 3 percent of women. It is often first diagnosed in women who are having their first child in their late 30’s and 40’s. This is because breast cancer risk increases with age.
Breast changes during breast feeding
During pregnancy the hormone levels for estrogen and progesterone fluctuate which in turn causes changes in the breast. The breasts will become tender and sore right after conception. The Montgomery’s gland (pigmented region around the nipple) darkens. The dark area around the nipple (areola) becomes even darker than normal.
Women will notice the increase in breast size during pregnancy due to hormonal changes, because of fluid retention and expanding blood vessels. During the third trimester of pregnancy, levels of prolactin and oxytocin, which are two hormones responsible for producing milk, increase their production. However, some of the receptors will be blocked by estrogen or progesterone. The production of prolactin will decrease after the birth of the child and the hormonal levels will go back to normal. The breast will begin to produce milk, usually about three to five days after delivery. During this period a substance called colostrum is present in the breast milk. This substance is important for further developing the infant’s immune system. This substance contains antibodies and researchers believe it also protects an infant from developing allergies and asthma.
Prolactin produces the milk, but it is ozytocin, which actually delivers it after the baby, starts sucking on the nipple. There are other hormones such insulin, cortisol, and thyroid that are contained within breast milk as well. Many of these hormones will be present in the body for several months even after breastfeeding has stopped.
Lumps found in the breast
Doctors will want to exam the breast for lumps right after the pregnancy has been determined. It is often much easier to determine if lumps are present when the breasts are normal in size than when they have started to engorge. All through the pregnancy the breasts should be examined monthly. Normal routine mammograms are not performed when a woman is pregnant if she shows no signs of breast cancer.
Because of the increase in estrogen during pregnancy it is common for lumps to appear in the breasts. Fortunately most of them are benign, meaning non cancerous. These types of lumps include: cysts, which are an accumulation of fluid, a special type of cyst, filled with milk called Galactoceles, and Fibroadenomas, which are tumors. Please note that any pre-existing tumors may enlarge during pregnancy. Most of the problems with breasts during pregnancy are often caused by infections or viruses entering the body through the baby’s mouth.
Nipple discharge
It is again fairly common for the breast to leak a milky like substance during pregnancy and is usually nothing to worry about. Sometimes the discharge is bloody and causes distress to women. However, this blood is usually just a result of irritated milk ducts due to rapid tissue growth. It could also be due to the shedding of the cells that line the milk ducts or it could be caused by papilloma a non-cancerous wart like growth. Of course any breast changes should be reported immediately to the doctor who will take further tests to find out if the abnormalities are cancerous or not.
Breast cancer diagnosis
Your doctor will probably order an ultrasound because it is not harmful to the fetus and it does a very good job of distinguishing cysts from other growths. A mammogram can be done, provided there is proper shielding. Mammograms emit low levels of radiation, however, do not worry the radiation will not be strong enough to affect mother or fetus. The doctor will often require a needle biopsy to examine breast cells under the microscope or remove a piece of the tissue mass. This is done because imaging testing does not always pick up breast cancer and examining the actual cells will provide a better diagnosis.
Breast cancer during pregnancy
It is not necessary to end a pregnancy because of breast cancer. Breast cancer does not harm the fetus, however some treatment options may. Drug therapy, radiation and chemotherapy are not usually administered during pregnancy. Surgery is the most common treatment of choice. Radiation, chemotherapy and drug therapy are usually administered after the baby is delivered and women are cautioned not to breastfeed during the treatment.
Women in their 40’s who have undergone chemotherapy may have fertility issues. Women who have had breast cancer can usually become pregnant again two or three years after the breast cancer treatment. However, some women find they do not produce enough milk in the breast, which has been treated. They have no problem with the other breast. Finally women who have had advanced cancer are not advised to risk another pregnancy. In the end the choices you make about pregnancy and breast cancer should be talked over with your doctor.
HYPERLINK “http://imaginis.org/breasthealth/benign.asp” l “fibroadenoma”