(LEUVEN, Belgium) — Chemotherapy for breast cancer can be safe during the second and third trimesters of pregnancy, according to a new report in The Lancet. Also, terminating the pregnancy does not appear to improve the mother’s prognosis.
“The situation remains challenging since in some situations an advanced cancer can be fatal for mother and fetus,” said Dr. Frédéric Amant of the Leuven Cancer Institute in Belgium, lead author of the report. “The patient and her partner should be informed about the different treatment options and the physician should explain that termination of pregnancy does not seem to improve maternal outcome, but the decision to continue or end the pregnancy is a personal one.”
In a separate study published in The Lancet Oncology, children whose mothers underwent chemotherapy during pregnancy were found to be normal on measures of general health, behavior and growth out to 18 years of age.
Although pregnancy does not increase the risk of breast cancer, the decision by some women to delay motherhood might be increasing the number of pregnant women with cancer, according Lillian Shockney, a breast cancer nurse at Johns Hopkins Hospital in Baltimore.
“We know age is a risk factor and so is having your first child after age 30,” said Shockney, who is also an associate professor of surgery, gynecology, oncology and obstetrics at Johns Hopkins University School of Medicine.
Pregnancy also causes breast changes that can mask the signs of cancer, delaying the diagnosis.
“I think a key message for women having babies if they see something different about their breasts — even if a doctor says, ‘Oh, your breasts are going to change because you’re pregnant’ — go to a breast center for a clinical exam,” she said. “Changes in one breast, not both, are a classic sign that something’s wrong. Follow your instincts.”
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