Because we cannot know who and when “breast cancer” will occur, for pregnant mothers and breastfeeding mothers themselves… this unexpected event can also happen. Is the lump in the breast cancer? If cancer is found, will it be dangerous to the fetus? And what about the breast milk… can it still be fed to the baby? Dr. Komol Prechasananongkit, a breast cancer specialist surgeon at the Raktaen Breast Center, Phyathai 2 Hospital, will clarify these questions!!
A lump in the breast… may not always be cancer
When a lump is detected, we need to see whether the lump is a solid mass or a cyst. If it is a cyst, it means it is not cancer… or what we call a “cyst”. Normally, cysts enlarge according to hormones, and during pregnancy, hormones increase… so it is possible that the cyst will also grow in size.
Can pregnant mothers undergo mammogram screening?
If a pregnant mother finds a lump or experiences breast pain and suspects cancer, mammogram screening “cannot be performed” due to radiation exposure. Therefore, before performing a mammogram, if the patient has missed her period for several months, the doctor must check if she is pregnant. If pregnant, mammogram cannot be done… only ultrasound can be used!!
How is ultrasound different from mammogram? Is it dangerous for the mother and fetus?
Mammogram is used to check for calcifications but cannot detect lumps or cysts, unlike ultrasound which can detect lumps or cysts. Due to the dense breast tissue, mammogram screening in Thailand is usually accompanied by ultrasound! Ultrasound has no harmful effects on pregnant mothers or the quality of breast milk during breastfeeding.
If breast cancer is detected in a pregnant mother… does she have to terminate the pregnancy?
If detected at an early stage, some cases may only require surgery, which does not affect the pregnancy. However, if chemotherapy or radiation therapy is needed, treatment may be postponed until the fetus’s organs are fully developed or after the third trimester, as it is relatively safer. In most cases, after surgery, treatment with chemotherapy is usually delayed until after delivery. “But in Thailand, there is no indication that breast cancer requires abortion or termination of pregnancy.”
Does this treatment delay affect the chance of cure?
Breast cancer is a systemic disease, meaning it is not only in the breast but also spreads throughout the body and blood. Surgery is like sweeping the floor, removing only the large debris, while chemotherapy or hormone therapy is like mopping to remove the fine dust completely. Therefore, delaying treatment carries risks! But since chemotherapy also affects the development of the fetus’s organs, this risk must be discussed with the patient first!
What about breastfeeding mothers… do they have to stop breastfeeding?
Because cancer spreads in body cells or blood, we do not recommend breastfeeding to continue. Breastfeeding can cause cell proliferation, making cancer cell control difficult. Therefore, we mostly recommend “stopping” breastfeeding.
Because the earlier breast cancer is detected, the higher the chance of successful treatment, breast examination before pregnancy or during the first trimester to check for abnormalities is a practice to better reduce the risk of breast cancer…
Dr. Komol Prechasananongkit
Breast Cancer Specialist Surgeon
Raktaen Breast Center Phyathai 2 Hospital
