Pregnancy-Associated Breast Cancer Diagnosis and Treatment

The second most typical malignancy that affects pregnancy is breast cancer. Breast cancer discovered during pregnancy or the first postpartum year is referred to as pregnancy-associated breast cancer (PABC). Your treatment options may be more difficult if you are diagnosed with breast cancer while expecting a child since you will want to seek the finest care possible for your illness while also safeguarding the unborn child. Your cancer care team and your obstetrician will have to meticulously prepare and coordinate the type and timing of therapy.

The goal of treating a pregnant woman with breast cancer is the same as treating a non-pregnant woman: to cure the cancer whenever possible, or, if that is not possible, to control it and prevent it from spreading. However, the added concern of safeguarding a developing foetus may make treatment more challenging.

Few studies address the optimal management and therapy options for PABC because it is a very uncommon event complicated by many characteristics. Together, let’s investigate the therapies.

Can A Woman Get Breast Cancer During Pregnancy?

Although it is uncommon because the breast cancer is unrelated to the pregnancy, it is possible to receive a breast cancer diagnosis while you are pregnant. Because they are worried about the well-being of their unborn child, women who receive a breast cancer diagnosis while pregnant are under a great deal of added stress. Despite the fact that the situation might be traumatising and incredibly challenging, there is still hope for both mother and child because of the many therapy choices available.

If you have been given a diagnosis of cancer and are pregnant, it never hurts to confirm that your oncology team and the members of your obstetric care team are in regular touch with one another. Your medical team will carefully develop a treatment plan to manage breast cancer while protecting your unborn child.

How Is It Diagnosed?

Visiting your doctor frequently is the finest thing you can do while pregnant. Prenatal (or “before birth”) checkups are what these appointments are known as, and they’re essential for maintaining the greatest possible health for both you and your unborn child. You might get breast exams to look for changes during some of these visits.

Although mammography is generally considered safe during pregnancy, because of the increased density of the breasts, it might not be as beneficial. A three-dimensional mammography may be preferable.

Your physician should do a biopsy if a suspicious lump is discovered. They will use a needle or a small cut to retrieve a small sample of the questionable tissue. To screen for any cancer cells, the sample tissue is examined under a microscope and using other techniques. Additionally, your doctor might do an ultrasound on you to determine the severity of any disease and to direct the biopsy.

Breast Cancer Treatment During Pregnancy?

Get professional advice and make sure you are aware of all your options if you are pregnant and have breast cancer because you may have to make difficult decisions. Although the timing and type of treatment may be impacted by pregnancy, pregnant women can safely receive treatment for breast cancer. Your recommended course of treatment if you have breast cancer and are pregnant depends on:

  • The tumour’s dimensions
  • The place where the tumour is
  • How far has the cancer spread
  • How far along in your pregnancy you are
  • Your general well-being
  • What you prefer

Surgery for breast cancer while you are pregnant is generally safe. If administered during the second or third trimester of pregnancy, chemotherapy appears to be safe for the unborn child, but not during the first. Other breast cancer therapies like radiation therapy, targeted therapy, and hormone therapy are less common during pregnancy because they pose a greater risk to the developing foetus.

The best-known course of treatment for the mother may conflict with the baby’s health, complicating treatment decisions. For instance, a woman might be counselled to consider terminating the pregnancy if she is diagnosed with breast cancer early in her pregnancy and requires immediate chemotherapy. Your healthcare team should also include a counsellor or psychologist to help provide you with any necessary emotional support.

As previously noted, the size, spot, and span of your pregnancy will all affect your treatment approach. Surgery is typically the initial step in treating early-stage breast cancer in women who are not pregnant. Your medical team will likely proceed with a lumpectomy or mastectomy and potentially some lymph nodes from beneath your arm because surgery can be safely done during pregnancy with little harm to your unborn child.

Depending on the type of cancer you have and the stage of your pregnancy, chemotherapy may be an option for treatment. Chemotherapy can be administered during certain windows of time during pregnancy without endangering the unborn child.

Radiation cannot harm an unborn kid, thus if it is advised, it is always administered after the baby is born.

It is unclear exactly how hormone therapy affects unborn children. Because of this, hormone therapy will probably only be given after the baby is born if it is prescribed.

Can A Mother Breastfeed During Breast Cancer?

No proof stopping your breast milk production would help your cancer. When you have this disease, it’s frequently good to breastfeed, but check with your doctor or a lactation consultant to determine what’s best for you and your baby. It is probably best to stop breastfeeding if you are receiving chemotherapy as numerous potent chemotherapy medications can reach the infant through your milk.

Survival Rates For Breast Cancer?

It may be more difficult to detect, identify, and treat breast cancer while pregnant. According to the majority of research, breast cancer patients who are pregnant or not and are diagnosed at the same stage often have similar outcomes.

For some women with advanced breast cancer, some doctors may advise terminating the pregnancy because they think it might delay the progression of the disease. Research in this field is challenging because there aren’t any high-quality, unbiased studies. Pregnancy termination simplifies therapy, but there is now no proof that it enhances a woman’s overall survival or cancer prognosis.

Studies have not demonstrated that treatment delays—which may be necessary during pregnancy—had an impact on the course of breast cancer. However, research on this subject as well has proven to be challenging. Furthermore, there is no evidence that breast cancer can harm an unborn child. If you are battling this malignancy visit us at RRMCH and get your treatment started.

Weight Loss After 50 Years Of Age Reduces Breast Cancer Risk

Breast cancer is one of the most common cancers amongst women in India and worldwide. A recent study about women who lost weight at 50 and maintained a healthy weight thereon showed a decreased risk of breast cancer as compared to women with more weight. This study is therefore a way to help women work around prevention of cancer.

Breast Cancer Risk

The study is published in the Journal of the National Cancer Institute. In USA over two third of the adult women are overweight or obese. The study was carried out by the researchers at the American Cancer Society, Harvard T. H. Chan School of Public Health using the Pooling Project of Prospective Studies of Diet and Cancer (DCPP) in order to determine the connection between sustained loss of weight after menopause or later adulthood and the risk of breast cancer.

The study involved over 180,000 women over 50 years of age across 10 studies. The sample size is huge and this analysis is the first to assess the breast cancer risk impact over sustained weight loss. The study did examine weight three times across 10 years period viz. at the time of enrollment, post five years and again four years thereafter.

The results showed that women who were able to reduce more weight in later adulthood and sustained it were able to lower the risk of breast cancer. The women who were able to shed around 9 kg’s of weight and then game some of it but not all did show a significant reduction in breast cancer risk.

The lead author of the study Lauren Teras, PhD says ‘These findings may be a strong motivator for the two thirds of American women who are overweight to lose some of that weight. Even if you gain weight after age 50, it is not too late to lower your risk of breast cancer”.

*Sourced from Internet

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Hodgkin Lymphoma – A Sneak Peek

One of the common cancers across the world, Hodgkin Lymphoma affects the lymphatic system of the body. The cancer causes the cells in the lymphatic systems grow uncontrollably and spread across the body. There are mainly two types of lymphoma cancers, Hodgkin Lymphoma (HL) and the other Non-Hodgkin Lymphoma (NHL). The latter is much more common as compared to the first one. The treatment is different for both and hence it’s vital to know what kind of lymphoma you suffer from.

Hodgkin’s Lymphoma usually occurs around 20 to 40 years of age of after 55. The risk factors for this condition include a family history with the condition and a history of Epstein Barr infection. The condition is most common in between 15 and 30 year olds and particularly males.

The diagnosis requires a physical examination and blood tests, imaging tests or biopsy if lymph node as well as bone marrow if needed. The treatment is based on the diagnosis and the stage of cancer. The Hodgkin’s lymphoma has four stages of cancers.

Cancer Stages

Stage 1 – It’s the preliminary stage of cancer when it is limited to the single organ or lymph node only.

Stage 2 – If the cancer has spread through other lymph nodes and another nearby organ as well, it is stage 2.

Stage 3 – Stage 3 cancer is when the cancer spreads to lymph nodes both above and below the diaphragm.

Stage 4 – Known to be the most advanced stage of Hodgkin’s lymphoma, Stage IV is when the cancer is spread through lymph nodes as well as other parts of the body like lungs, bones and liver.

If diagnosed at an early stage the cancer can be cured to a great extent and even the life expectancy levels increase. Though, accurate diagnosis is the key and it requires an expert pathologist to do so because there have been a lot of cases of misdiagnosis based on biopsy tests due to lack of experience. So, a good idea is to take second opinion even if it is diagnosed.

Treatment

Based on the diagnosis, the treatment involves chemotherapy sessions that uses chemicals to treat the affected cells. Post the chemotherapy, radiation therapy is carried out. At times they are done in combination. While chemotherapy can be done using pill or even through veins, radiation therapy involves usage of high energy rays like protons and X-rays to kill the cancer causing cells. The therapy is spread over several weeks and is carried out daily for half an hour period. Another option that could work is bone marrow transplant but there is a possibility of underlying infection risk. Targeted therapy is another kind of treatment that focuses on targeting specific cells and immunotherapy works in activating your immune system to fight these cancer cells. If these treatment are of no use then genetic mutations is another way that involves using drugs that target specific mutations of the lymphoma cells. Targeted therapy is the latest in cancer treatment options and is under research.

*Sourced from the Internet

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Ductal Carcinoma in Situ (DCIS) & Mastectomy

In India Breast Cancer is the top occurring cancer amongst females with a mortality rate of 12.7 per 1,00,000. A non-invasive form of breast cancer, Ductal carcinoma in situ (DCIS) is a common form of cancer in India. Ductal means ducts as its starts in the milk ducts and carcinoma means cancer that starts in the skin or any other tissues covering the internal organs and in situ means in its original place. The reason this cancer is known as non- invasive cancer is that is has not spread beyond the milk duct to the neighboring tissues.

DCIS is a grade 0 cancer and is not a life threatening cancer but having it in first place does increase the risk of developing an invasive breast cancer later on compared to people who haven’t had it before. The possibility of recurrence is usually 5 or 10 years post the first appearance with a 30% likelihood.

Ductal carcinoma in situ (DCIS)

The possibility of recurrence in women undergoing the breast conserving surgery is around 25% to 30% . To lower the risk of recurrence by 15% you need to include radiation therapy in the treatment plan. Also, if DCIS comes back after treatment it could either be non-invasive or invasive too, chances are 50% for each.

Here’s a look through the symptoms, causes, diagnosis and treatment of the condition.

DICS – Symptoms
Generally there are no visible symptoms of DCIS. Only a few people might have a lump in the breast or some nipple discharge. Diagnosis is only possible for most of the cases through mammography.

DICS – Diagnosis
Breast Examination – A physical examination of breasts is carried out if a lump is present though such lump is rarely noticeable.

Mammography – A mammography can easily detect DCIS. Even when a physical examination fails, mammography can be used to detect DCIS.

Biopsy – Biopsy is only carried out when a mammogram does not give a clear result. There are two kinds of non-invasive biopsies which involve a bit of surgery.

  •  Core needle biopsy – A large needle is inserted for a big sample of tissue from the suspicious area.
  •  Fine needle biopsy – A sample of cells are obtained by inserting a small hollow needle in the breast and then examining it under the microscope.

Though more invasive biopsies are rarely need for DCIS, if the above are not able to give conclusive results then biopsies like incisional and excisional biopsy’s are to be done.

Treatment – Once the diagnosis confirms DCIS, surgery is done to remove the cancer as well as the border of the healthy tissues surrounding the cancer, known as the clear margins. This means doing the procedure of lumpectomy or sometimes mastectomy.