Heart Failure: What It Is, Causes, Symptoms, and Treatment
Heart failure is a medical condition that affects the heart's ability to pump blood efficiently. This condition can have serious implications for overall health, as...
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Breast cancer during pregnancy, although infrequent (accounting for 1-3% of all breast cancer cases), is not an insignificant occurrence. It is estimated that for every 10,000 pregnant women, 1 to 7 breast cancer diagnoses are made.
Several factors during pregnancy can delay the diagnosis of breast cancer and potentially promote the spread of the disease. Firstly, medical professionals are often more focused on the overall health of the pregnant woman and the fetus, rather than looking for potential breast pathologies. Secondly, the diagnosis is complicated by the natural increase in breast volume and density during pregnancy.
Mammography is not necessarily contraindicated during pregnancy as the radiation exposure to the fetus is minimal. However, it can be difficult to interpret due to the increased density of the breast tissue. Ultrasound can offer more precise information about the structure of any nodules, but it is essential to conduct a fine needle aspiration or a surgical biopsy promptly for an accurate diagnosis.
The prognosis for patients who develop breast cancer during pregnancy is not worse than that of non-pregnant patients of the same age and at the same disease stage. Likewise, terminating the pregnancy does not improve the patient's survival rate. Termination is only considered if continuing the pregnancy would significantly delay the administration of necessary chemotherapy and radiotherapy, particularly during the first trimester.
Surgical intervention on the breast during pregnancy does not pose significant risks to the fetus. The second trimester is often considered the most favorable period for surgery, although even in the first trimester, the risk of miscarriage or fetal damage due to anesthesia is relatively low. However, radiotherapy cannot be performed during pregnancy due to potential risks to the fetus, including the possibility of childhood tumors.
Chemotherapy is associated with an increased risk of fetal malformation in the first trimester, but likely not in the second or third trimester. However, it can cause premature birth or growth defects. Hormone therapy, on the other hand, is contraindicated during pregnancy.
The treatment of breast cancer during pregnancy is a complex issue, influenced by the extent of the disease and the gestational stage. For initial forms of the disease, prompt surgical treatment is necessary, unless the natural end of the pregnancy is near.
Most oncologists recommend waiting at least two years after completing treatment before attempting pregnancy. This period is considered critical because the risk of cancer recurrence is highest during the first two to three years following diagnosis. Waiting allows doctors to monitor your health closely and detect any potential recurrence before pregnancy.
For patients who have undergone conservative surgery, breastfeeding can be challenging due to tumors located near the nipple. Approximately 70-75% of these patients are unable to breastfeed from the operated breast.
In conclusion, breast cancer during pregnancy is a complex and challenging situation that requires careful management. It is critical that patients are given comprehensive information and support to navigate their treatment options, and that they are closely monitored during and after their pregnancy.
