article from The National Cancer Institute

​Breast cancer is the most common cancer in pregnant and postpartum women, occurring in about 1 in 3,000 pregnant women. The average patient is between 32 and 38 years of age and, with many women choosing to delay childbearing, it is likely that the incidence of breast cancer during pregnancy will increase.

The natural tenderness and engorgement of the breasts of pregnant and lactating women may hinder detection of discrete masses, and therefore, early diagnoses of breast cancer. Delays in diagnoses are common, with an average reported delay of 5 to 15 months from the onset of symptoms. Because of this delay, cancers are typically detected at a later stage than in a non-pregnant woman of the same age. To detect breast cancer, pregnant women and lactating women should practice self-examination and undergo a breast examination as part of the routine prenatal examination by a doctor. If an abnormality is found, diagnostic approaches such as ultrasound and mammography may be used. With proper shielding, mammography poses little risk of radiation exposure to the baby.

Some factors associated with pregnancy are known to reduce a woman’s chance of developing breast cancer later in life:
• The younger a woman has her first child, the lower her risk of developing breast cancer during her lifetime.
• A woman who has her first child after the age of 35 has approximately twice the risk of developing breast cancer as a woman who has a child before age 20.
• A woman who has her first child around age 30 has approximately the same lifetime risk of developing breast cancer as a woman who has never given birth.
• Having more than one child decreases a woman’s chances of developing breast cancer. In particular, having more than one child at a younger age decreases a woman’s chances of developing breast cancer during her lifetime.
• Although not fully understood, research suggests that pre-eclampsia, a pathological condition that sometimes develops during pregnancy, is associated with a decrease in breast cancer risk in the offspring, and there is some evidence of a protective effect for the mother.
• After pregnancy, breastfeeding for a long period of time (for example, a year or longer) further reduces cancer risk by a small amount.

Some factors associated with pregnancy are known to increase a woman’s chances of developing breast cancer: 
• After a woman gives birth, her risk of breast cancer is temporarily increased. This temporary increase lasts only for a few years.
• A woman who during her pregnancy took DES (diethylstilbesterol), a synthetic form of estrogen that was used between the early 1940s and 1971, has a slightly higher risk of developing breast cancer. (So far, research does not show an increased breast cancer risk for their female offspring who were exposed to DES before birth. These women are sometimes referred to as “DES daughters”.) There are a number of misconceptions about what can cause breast cancer.

These include, but are not limited to, using deodorants or antiperspirants, wearing an underwire bra, having a miscarriage or induced abortion, or bumping or bruising breast tissue. Even though doctors can seldom explain why one person gets cancer and another does not, it is clear that none of these factors increase a woman’s risk of breast cancer. In addition, cancer is not contagious; no on can “catch” cancer from another person.

​A woman can be an active participant in improving her chances for early detection of breast cancer. NCI recommends that, beginning in their 40s, women have a mammogram every year or two. Women who have a higher than average risk of breast cancer (for example, women with a family history of breast cancer) should seek expert medical advice about whether they should be screened before age 40, and how frequently they should be screened.  

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by Julie Borton

Being diagnosed with breast cancer is scary enough, but imagine being 13 weeks pregnant and getting that diagnosis. It was at my 12 week prenatal visit that a suspicious spot was found on my left breast. My OB doctor thought that it was inflamed breast ducts from being pregnant.

However, just to be safe she sent me over to Covenant’s Breast Center to have it checked out. While over there the doctor did an ultrasound which appeared normal, and then did a needle biopsy just to put everyone at ease, so he thought. To everyone’s disbelief, including the doctor’s, the biopsy came back with malignant cells. On February 5, 2007 an excisional biopsy was done.

That is the day that will haunt me forever. The official diagnosis: breast cancer, Stage 2 invasive ductal carcinoma.

So there I was 13 weeks pregnant and scared not only for my life but for our unborn child, the two girls at home, my husband and our families. What was the next step...termination of the pregnancy, mastectomy and chemo while pregnant or start treatment after pregnancy??? Termination was not an option for us. So we decided the first step was to continue the pregnancy and have a mastectomy. February 19, 2007 I had a radical left mastectomy.

They removed 17 lymph nodes and two came back positive, all of the margins were clear. After a consult in Iowa City with their oncology staff and high risk prenatal clinic the decision was made to start chemo while pregnant. Breast cancer is very treatable and their goal was to cure me and have a healthy baby. I think this was the most positive appointment I could have had while being shell-shocked.

Crazy as it sounds chemotherapy (Adriamycin and Cytoxan) are safe to have and will not harm the baby. The next five months became a whirlwind. Chemo every 21 days at Covenant Oncology, prenatal visits every two weeks at the Rellihan, Weno and Hines Clinic for Women to monitor the growth of the baby.

Other than not gaining weight, there were no complications during the pregnancy. My body handled the chemo well, the hair loss was traumatic for me but it was just another obstacle to overcome. Jonathan was born at Covenant Medical Center on July 5, 2007, six weeks early, with no major complications. He was 5 lbs. 5.6 oz., and 18 inches long. He was in NICU for five days and went home, only to return at 12 days old due to periodic breathing episodes. He spent 10 more days in the hospital.

It is now 10 months after my diagnosis and we have a healthy baby boy. I have completed all my treatments. I am now preparing to have a right mastectomy and a hysterectomy. If I could give any advice it would be to explore all options, know that chemo is possible while pregnant, keep your faith and keep living for tomorrow. I could not have made it through this without my trust in God, and the support of my husband, my family, friends and the community.

I am more than happy to share more details about my experience either personally or view my Web site at: www.caringbridge.org/visit/julieborton To contact me personally, call me at 319-239-0534 or my e-mail address is: bjborton@netins.net

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