Pregnant and breast cancer – what now?

Will my breast cancer treatment be different if I am pregnant?

The treatment of pregnant women with breast cancer is based on the standard treatment of young, non-pregnant patients without breast cancer. “We tailor diagnostics and treatment to the respective week of pregnancy, discuss all options in detail with the pregnant patient and her partner and work closely with the obstetrics clinic so that we can provide comprehensive treatment for mother and child,” explains Isabell Witzel.

However, there are some differences in treatment, explains Isabell Witzel, who also runs the Breast Cancer Center of the USZ: “Immunotherapies and antibody treatments, which are often given in combination with chemotherapy, are not allowed during pregnancy. Radiation is also avoided, since the radiation exposure for the unborn child should remain as low as possible to prevent possible damage. However, chemotherapy can be carried out during pregnancy without harming the child, so we often choose this option.” The clinic director emphasizes that there are no increased rates of malformations or other long-term damage, such as organ damage or developmental delays, in unborn children.

How do pregnancy checks and birth differ in breast cancer?

A pregnant woman with breast cancer has the same pregnancy examinations, but must be monitored more closely and more frequently. Every one to two weeks, the growth of the fetus and the amount of amniotic fluid are checked using ultrasound. And to see how the organs are developing. It is important to avoid stress and keep an eye on a few risk factors, explains gynecologist Nina Kimmich: “Chemotherapy often leads to increased nausea in pregnant women. And a reduction in red and white blood cells, which leads to anemia. Cancer therapy also increases the risk of infection.” A woman’s general condition can also be impaired by chemotherapy. “It therefore often makes sense to plan the birth during a break in treatment,” explains the head doctor at the obstetrics clinic: “This means we induce labor or opt for a caesarean section. Depending on the time of therapy, this can also be a few weeks before the expected date of birth and means a premature birth. “However, we always try to carry out the delivery when the child is sufficiently mature,” adds breast cancer specialist Isabell Witzel to her colleague’s comments. This demonstrates that an interdisciplinary and highly specialized team of obstetrics, breast cancer specialists and gynaecology work closely together at the USZ to ensure that both the pregnant cancer patient and the unborn child receive optimal treatment.