Study reveals the impact of breast cancer on pregnant women

Breast cancer in pregnancy is an uncommon condition and there is limited experience among individual practitioners in treating breast cancer diagnosed during pregnancy and little information about the best management for the mother or the expected outcomes of the pregnancy for the mother and her baby.

To fill this knowledge gap, the National Breast Cancer Foundation funded a study to explore the experience of pregnancy and birth for women diagnosed with breast cancer during pregnancy, to give a much needed ‘voice’ to the meaning and significance of being pregnant with breast cancer from the perspective of the women who have experienced it.

Professor Elizabeth Sullivan from the University of Technology Sydney has found that babies born to women diagnosed with breast cancer while pregnant have high rates of premature birth but excellent survival rates.

The study looked specifically at the outcomes of 47 women in Australia and New Zealand who proceeded with a pregnancy after being diagnosed with breast cancer, or who were diagnosed with breast cancer shortly after giving birth. The results were as follows:

• 77 per cent of women had breast symptoms prior to diagnosis, and 65 per cent of women with cancer had their birth induced in four out of five cases
•  42 per cent of babies were born prematurely, 25 per cent of infants were low birth weight and 32 per cent required admission to special care

Associate Professor Sullivan says she hopes this study will provide an evidence base for patients, as well as important guidance for obstetricians, oncologists and other allied health professionals about the diagnosis, management and outcomes of breast cancer experienced during pregnancy and, ultimately, to help provide optimal maternal and foetal care.

“It’s important to balance the treatment needs of the mother with the needs of the child. This study describes current practice and provides a good basis to examine approaches to maternity and cancer management,” said Professor Sullivan.

Professor Christobel Saunders, investigator and cancer surgeon on the study says, “We know that treatments such as chemotherapy can safely be delivered at any time during pregnancy after the first trimester.

“However, it appears this message is not always getting through to women or their obstetricians who often opt for early delivery rather than undergoing the important cancer treatment during pregnancy.

“It was also encouraging to see that almost half of women diagnosed during pregnancy initiated breast feeding,” said Professor Saunders.

The qualitative research from Professor Sullivan’s colleagues also highlighted some of the psychological concerns pregnant women with cancer experience.

“Pregnancy is usually a time of joy, but cancer changes that. The combination of expecting new life and having a life threatening illness is psychologically extremely challenging and confronting,” said Professor Sullivan.

“The key factor that had the biggest impact on a woman’s experience of care was the quality of communication with and between the cancer and maternity care teams. Breast cancer nurses were also highly valued.”