Pregnant women should receive extra cancer tests, urges specialist

A LEADING cancer specialist has called for doctors to perform extra tests on pregnant women to reduce the risk of failing to detect breast cancer.

Dr Blanca Hernando, a Spanish oncologist, has warned that diagnosis is too often delayed because both doctors and pregnant women assume that lumps in the breast are due to normal hormonal changes.

Speaking at the European Society for Medical Oncology conference in Edinburgh at the weekend, Dr Hernando of the University Hospital Clinic in Valencia, said that the threat of breast cancer in pregnant women was not uncommon.

“The obstetrician is usually more focused on the health of the unborn baby than the mother’s possible illness but should be more aware of the risk of breast cancer,” said Dr Hernando.

Here there are over 1,700 new cases of cancer each year with Irish women estimated to have a one in 13 chance of developing breast cancer in their lifetime. However, there is no separate data on the incidence of the disease on pregnant women in Ireland.

Dr Hernando said there was a high rate of false-negative results of mammograms on pregnant women due to the increased density of the breast in pregnancy.

In a study of 18 pregnant women with breast cancer, there was a 10-week delay in the diagnosis which resulted in women first receiving treatment after the disease had progressed. All the patients had surgery to remove the lump and chemotherapy. Four women diagnosed in the first three months of pregnancy had an abortion.

Dr Hernando said that many studies had shown that tumours in pregnant women are also larger and more likely to spread.

However, she stressed that pregnant women should be encouraged to know that treatment is as successful and safe as in non-pregnant women.

According to Dr Hernando, surgery is the best route although there is a small risk of premature labour. Radiation is not offered to pregnant women, but patients could still be treated with certain forms of chemotherapy from three months onwards. Treatment may also be continued after the birth of the baby, although mothers should not breastfeed their babies while receiving chemotherapy.

“Breast cancer during pregnancy has about the same prognosis as other breast cancer, when compared to women of a similar age,” said Dr Hernando.

“The most important thing is to be diagnosed and treated at an early stage to prevent it spreading to other parts of the body.”