Pregnancy Associated Breast Cancer

Clare O’Neill, CoppaFeel! Healthcare Engagement Coordinator

21st January 2020

We were recently contacted by a 29-year-old woman who was diagnosed with breast cancer during pregnancy. This is what she told us:

“The GP agreed there was a definite lump but I was told because I was under the age of 30 and pregnant, I won’t be referred as it’s likely to be changes to the breast experienced during pregnancy. If it was still there in 4 weeks I should return and they would consider referring me. However, it didn’t sit right to wait another 4 weeks. I think I waited 2 weeks in the end and called my surgery. The second doctor said she would send a standard referral which could take 4-6 weeks. Thankfully the next day I received a phone call from the hospital who booked my appointment for me just 3 days later.

“Luckily it has been caught nice and early and I am so hopeful! My cancer journey starts now and I don’t know what exactly it will look like, but had it not have been for CoppaFeel! I wouldn’t have ever known to check my boobs. I’m very much looking forward to welcoming my baby girl and planning a pretty epic 30th birthday next year!”

All women should feel empowered to take control of their breast health, and not ignore concerning symptoms during pregnancy. CoppaFeel! support healthcare professionals to educate and encourage women, so that when PABC sadly occurs, we see the signs earlier.

At CoppaFeel! we know that knowing your boobs can save your life. Younger women are not routinely screened for breast cancer, so we encourage them to get to know their boobs and educate them on the signs and symptoms of breast cancer. However, we also know that recognising those signs and symptoms can be more difficult for women who are pregnant and/or breastfeeding. Boobs change during pregnancy, but regular boob-checking can prevent late diagnosis, so our breast awareness message remains the same for women before, during and after pregnancy.

Here’s why: Pregnancy-Associated Breast Cancer (PABC) – breast cancer that is diagnosed during pregnancy or up to a year post-partum – is on the increase. Whilst still rare, 1 in 3,000 pregnant women will be diagnosed with breast cancer every year. That means roughly 200 women a year in the UK are diagnosed with breast cancer whilst pregnant. Pregnant women diagnosed with breast cancer are also more likely to be diagnosed at a late stage than women who are diagnosed in the general population. Studies have shown that pregnant women with breast cancer presented with more advanced disease, this was attributed to difficulties diagnosing PABC.

So, how can we see the signs of PABC when they are so similar to normal breast changes in pregnancy? Our first aim is to empower women to get to know their boobs in pregnancy, that means getting to know their ‘new normal’. Regardless of pregnancy, breasts often change due to normal hormonal fluctuations, but we want women to keep checking, get informed and feel confident to see their GP with any new unexplained symptoms. 90% of patients who attend the breast clinic are not given a breast cancer diagnosis, so we encourage GPs to refer women to the breast clinic when in any doubt. The most common diagnostic tool for young breast tissue is ultrasound, so a referral to the breast clinic is perfectly safe for pregnant women, and it’s better to be safe than sorry.

Resources

Cancer Research UK & Public Health England National Cancer Registration and Analysis Service, 2018.

https://www.ncbi.nlm.nih.gov/pubmed/18591310/

Keyser EA, Staat BC, Fausett MB, Shields AD. Pregnancy-associated breast cancer. Rev Obstet Gynecol. 2012;5(2):94-9.