Answer:

Gestational breast cancer is diagnosed during pregnancy or within the first one year postpartum. While the incidence of gestational breast cancer is not high, the prognosis is often poor due to delayed diagnosis. Before planning a pregnancy, in addition to screening for infectious diseases, uterine, and ovarian conditions, women should also have their breasts checked to prevent the risks of breast cancer, which can affect both the mother and the fetus.

During pregnancy, women typically experience increased levels of estrogen, progesterone, hCG, and prolactin hormones. These hormones stimulate significant breast development in preparation for lactation, which can unfortunately accelerate the growth of breast cancer cells.

Doctor Vinh consults a patient. Illustration: Tam Anh General Hospital

During pregnancy, the rapid proliferation of lobules and milk ducts, increased blood flow to the breasts, and an increase in breast volume and tissue density can cause swelling, hardness, and pain. These changes make the diagnosis of gestational breast cancer difficult and often lead to delays. Such changes are easily confused with normal physiological phenomena of pregnancy, such as blocked milk ducts or mastitis. Most patients are diagnosed with large tumors that have invaded the skin, metastasized to lymph nodes, and spread to distant organs like the liver, bones, and lungs.

Screening methods like MRI and mammography, which help detect breast cancer, are often restricted for pregnant women in the first three months. MRI with contrast dye is absolutely contraindicated as the dye passes through the placenta. Biopsies during pregnancy can yield false positive or false negative results due to changes in breast tissue structure. More importantly, treating gestational breast cancer presents many challenges. Surgery requires careful consideration of anesthesia risks. Radiation therapy and hormonal therapy are not indicated throughout pregnancy, while chemotherapy can only be performed cautiously during the second and third trimesters, still carrying risks of preterm birth and miscarriage.

If you are planning a pregnancy, you should undergo breast screening 3-6 months in advance with an oncologist. If benign lumps are detected, patients can be monitored or undergo safe surgery. In cases of malignant tumors, patients receive treatment to ensure their health before conception.

Dr. CKI Le Ngoc Vinh

Oncology Surgery Department, Oncology Center

Tam Anh General Hospital TP HCM