Physiologic changes of pregnancy, such as increased breast volume and firmness, present challenges to detecting breast cancer. Meeting those challenges requires “education and continued diligence, both on the patient side as well as on the physician side,” Luis Zabala Blanco, Jr, MD, said in an interview with The ASCO Post. Dr. Blanco is Associate Professor, Department of Pathology, and Director of the Breast Pathology Fellowship at Northwestern University Feinberg School of Medicine, Chicago.

“If the patient feels something, or the physician feels something during an exam, it should be taken seriously, because these cancers will do better the sooner they are detected,” Dr. Blanco explained. This is true even though a patient may not necessarily be treated while pregnant, and most women who are diagnosed with beast cancer during pregnancy wait until after the baby is born before starting treatment.

Many women are surprised when they are diagnosed with breast cancer during pregnancy. “Pregnancy-associated breast cancer occurs in women who tend to be younger, on average 34 or 35 years old,” Dr. Blanco noted, “and that is before we even start mammography screening (age 40). So, unless patients have a family history or other high-risk factors, they would never have had a mammogram or breast magnetic resonance imaging at that point.”

Later Pregnancies

“Pregnancy initially causes an increased risk of breast cancer, and that risk is most pronounced the later the first pregnancy occurs,” Dr. Blanco told The ASCO Post. When Dr. Blanco presents information at conferences about this increased risk, some members of the audience are surprised to learn that.

Education is needed, he said, to fill that knowledge gap. “In general, it is more well known that pregnancy is protective against breast cancer, which is true. However, there is that initial risk for breast cancer of which a lot of people are unaware.” 

DISCLOSURE: Dr. Blanco reported no conflicts of interest.