Cancer is a topic no one wants to think about.
Especially breast cancer during pregnancy or postpartum breast cancer.
But here’s what I know to be true:
1) There is a small but real elevated risk of breast cancer during pregnancy and in the first 2-5 years postpartum.
2) Early detection saves lives.
3) There are breast cancer treatment options EVEN during pregnancy that don’t compromise your babe.
Pregnancy, Lactation And Breast Cancer Risk
To hit this one off at the pass:
“But I heard that childbirth and breastfeeding is protective of breast cancer.”
Yes. In the long run. But in the immediate perinatal chapter, there’s a small, but real increase in breast cancer occurrence (1).
And then a few years down the line, there’s an inflection point.
And childbirth and lactation become protective in the long-run.
What Is Pregnancy-Associated Breast Cancer?
Breast cancer diagnosed during pregnancy OR during the 2-5 years postpartum, is collectively called “pregnancy-associated breast cancer” (2).
The specific window varies source to source- Some people define “pregnancy” associated cancers as occurring during pregnancy through one year postpartum. Some folks would say that window is pregnancy through 10 years postpartum.
The EXACT time frame is not so important.
What is important, are the special challenges in diagnosing and treating breast cancer during this chapter, and in the types of cancers and prognosis of cancers diagnosed in this window.
What Makes Pregnancy-Related Breast Cancer Different?
Pregnancy-related breast cancers occur in ~1 in 3000 pregnancies (3).
It’s a small number y’all.
But here’s the problem- when they DO occur, they tend to be more aggressive (the hormone-receptor negative, Her2+ type OR triple-negative type) and they are often diagnosed at a more advanced stage (4).
Now I don’t know why the more aggressive cancers are more prevalent in this chapter- I don’t think science has an answer yet.
The overall increased risk is likely linked, in as a-yet-to-be-determined-way, to the hormonal fluctuations and breast changes associated with pregnancy.
But as to why they’re diagnosed at more advanced stages?
It’s because our breasts are undergoing SO many changes anyway.
They’re lumpy and bumpy.
They’re engorged and uncomfortable.
They’re changing sizes.
They’re becoming asymmetrical.
And that stuff is NORMAL during pregnancy and lactation.
And it can mask very real early signs and symptoms of breast cancer.
My Breast Cancer Diagnosis And Some Advice
I fall into this camp, y’all.
When my Her2+ cancer was diagnosed at 2 years postpartum, my doctors estimated that it had been growing for 2-2.5 years.
And I ignored the major symptom (nipple discharge) because I thought it was a hanger-on from breastfeeding my son.
I was lucky I got it checked out when I did, but I also would have been better (caught it before it hit my lymph nodes!) off if I would have had it checked out sooner.
So here’s my advice to you:
Know the signs and symptoms.
If something feels off, get it checked out and ADVOCATE for yourself if your provider brushes off your concerns.
Don’t give your body or your breast tissue an indefinite pass to do weird stuff after pregnancy.
Once your done breastfeeding, if you’re still lumpy/bumpy, leaking/asymmetrical- get evaluated.
What Happens If You’re Diagnosed With Breast Cancer During Pregnancy Or While Breastfeeding?
If you’re diagnosed with breast cancer during pregnancy or lactation, you’ve got options.
I won’t dive deep into those options here, instead, please check out the resources at the end of this post.
For our purposes here, I just want you to know this:
There are treatments available to you that don’t pose a danger to your fetus or your baby (5).
In the unlikely even you find yourself if the position of needing oncology care during this chapter, make sure you find providers experienced in your unique situation.
Don’t be afraid to seek multiple opinions. And always be your fiercest advocate.
Pretty much everything we do increases the risk of some cancer and decreases the risk of others.
We absorb risk all the time.
So this isn’t an article about risk reduction (and important topic, but it’s OWN topic).
I’m not telling you to avoid getting pregnant to reduce breast cancer risk (absolutely not!).
This is an article on understanding one particular risk that you need to acknowledge while LIVING your life.
I don’t want to scare you.
I only want you to be VIGILANT and have the knowledge to advocate for your health care needs.
👋🏾 What questions do you have?
Pregnancy Associated Breast Cancer with Dr. Kristin Robinson (Nicole Rankins’ podcast)
Treating Breast Cancer During Pregnancy (cancer.org)
(1) Pregnancy Confers ‘Dual Effect’ on Breast Cancer Risk, https://ascopost.com/issues/december-10-2022/pregnancy-confers-dual-effect-on-breast-cancer-risk/. Accessed 11 Mar. 2023.
(4) Suelmann, B. B. M., et al. “Pregnancy-Associated Breast Cancer: Nationwide Dutch Study Confirms a Discriminatory Aggressive Histopathologic Profile.” Breast Cancer Research and Treatment, vol. 186, no. 3, Apr. 2021, pp. 699–704.
(5) Treating Breast Cancer During Pregnancy. https://www.cancer.org/cancer/breast-cancer/treatment/treating-breast-cancer-during-pregnancy.html. Accessed 11 Mar. 2023.
My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Laura Jawad holds a PhD and a personal training certification (NASM). She’s a proud Certified Prenatal & Postnatal Coach and Pregnancy & Postpartum Athleticism Coach. You can check out the rest of her alphabet soup here.