Breast cancer during pregnancy

Treatment during pregnancy and after delivery

The following are treatments that you may be given depending on your trimester and whether you have delivered your baby. If you are near to the end of your pregnancy, your specialist may delay your treatment until after the birth. If you are breastfeeding you will be advised to stop before receiving any treatment.

Surgery

Surgery can safely be done during all trimesters of pregnancy. Many women with breast cancer are given a choice between mastectomy and breast-conserving surgery. A mastectomy is removal of all the breast tissue including the nipple area, while breast-conserving surgery, usually referred to as lumpectomy or wide local excision, is where the cancer is removed along with a margin of normal breast tissue. During pregnancy you’re more likely to be offered a mastectomy. This is because not all women who have a mastectomy need radiotherapy whereas radiotherapy is needed after breast-conserving surgery. Radiotherapy is generally not recommended at any time during pregnancy.

If you are diagnosed in your second trimester and will be having chemotherapy after your surgery, you may also be able to have breast-conserving surgery (if appropriate) instead of a mastectomy. This is because radiotherapy will not usually be given until after your chemotherapy has finished, and after your baby has been born.

Your specialist team will also want to check the lymph nodes under your arm (you may already have had a lymph node biopsy at the time of your diagnosis). If tests before your operation show that your lymph nodes contain cancer cells, an operation to remove all of your lymph nodes (a lymph node clearance) will be recommended. If not, you may be offered a sentinel lymph node biopsy to identify whether the first, or sentinel, lymph node (or nodes) are clear of cancer cells. If the biopsy shows the node (or nodes) are affected, you may be recommended an operation to remove some or all of the remaining lymph nodes.

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