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Breast Lumps During Pregnancy
Breast cancer during pregnancy can be difficult to diagnose because the breasts naturally undergo several changes. During pregnancy, the breasts increase in size and become more tender, especially during the first half of pregnancy. The most rapid period of breast growth is during the first eight weeks of pregnancy. As the pregnancy progresses, the breasts become firmer and more nodular to prepare for lactation (breast-feeding). It is very important for women to continue to perform monthly breast self-exams during pregnancy and receive monthly physician-performed clinical breast exams so as not to delay the possible diagnosis of breast cancer.
As in non-pregnant women, the majority of breast lumps found during pregnancy are benign (non-cancerous). However, because a lump can signal breast cancer, all persistent lumps should be evaluated by a physician. Approximately one in 3,000 (0.03%) to one in 10,000 (0.01%) women are diagnosed with breast cancer during pregnancy. Breast cancer itself does not appear to harm a fetus.
If a lump is detected during pregnancy, an ultrasound exam and/or mammogram will typically be performed. Ultrasound is excellent at distinguishing cysts (packets of fluid) and is routinely used for fetal imaging because it does not harm the fetus. Mammography is also considered safe for pregnant women and the fetus because it uses a very low dose of radiation. In many cases, a biopsy will be performed if a suspicious breast lump is detected in a pregnant woman. A biopsy confirms or denies the presence of breast cancer.
Non-cancerous conditions that are common during pregnancy include:
- Cysts (collections of fluid)
- Galactoceles (milk-filled cysts)
- Fibroadenomas (tumors; existing ones may enlarge during pregnancy)
If breast cancer is detected during pregnancy, it is not necessary to terminate the pregnancy. Treatment options should be discussed with the patient’s cancer team. Surgery, such as lumpectomy and mastectomy, can be performed safely during pregnancy. Radiation, chemotherapy, and drug therapies (such as tamoxifen) are usually delayed until after childbirth.
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