BREAST CANCER IN PREGNANCY: IS CHEMOTHERAPY SAFE FOR THE BABY?

The diagnosis of breast cancer In a pregnant woman it is a complex situation, since it is intended to offer the best treatment against the disease, while protecting the baby on the way.

What worries mothers most is that their illness or the chemotherapy treatment, both for breast cancer and for any other type of cancer, may harm the baby during pregnancy.

Chemotherapy in pregnancy

If breast cancer is detected during pregnancy, deciding the treatment to follow will depend on several particular factors: the size and location of the tumor, whether the cancer has spread or not, the time of gestation, the general state of the pregnant woman … Together with the doctor, all available treatment options should be considered and the most convenient in each case decided.

As for surgery to remove cancer in the breast and nearby lymph nodes, a very important part of the treatment is generally safe during pregnancy.

The European recommendations indicate that Pregnancy must be preserved if oncologically it is safe and feasible. A study conducted by researchers at the University Hospital of Leuven in Belgium, and presented at the European Cancer Congress in Vienna in 2015, concludes that there is no need to delay chemotherapy treatment in pregnant women with cancer after childbirth, since does not harm the fetus.

They analyzed 129 children born to pregnant women with cancer (96 of them treated with chemotherapy) and another 129 born to mothers without cancer, following their evolution until they had an average of two years.

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They verified that the treatment through the most common forms of chemotherapy does not affect the development of the baby and that, in addition, although there are more cases of premature babies and of low birth weight, they recover it later. Nor have they observed differences in congenital malformations, cardiac abnormalities, or in relation to cognitive development, at least until three years.

In conclusion, they found that the baby would be at greater risk by undergoing premature delivery than oncological treatment. Its main author assures:

"The data suggests that children suffer much more from being premature than from prenatal chemotherapy."

In the first quarter it is dangerous

Chemotherapy is not given in the first trimester, as it is a stage that is more susceptible to complications, due to the formation of major organs. But after the first 12 or 14 weeks of pregnancy Only a fraction of chemotherapy passes through the placenta and reaches the fetus.

"The decision to administer chemotherapy should follow the same guidelines as in non-pregnant patients. In practice," says Amant, "it is possible to administer chemotherapy. from 14 weeks onwards of gestational age, with special attention to prenatal care. "

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The authors stress that it has been shown that "children who were prenatally exposed to chemotherapy have a development similar to that of any other child."

Chemotherapy to treat cancer should be avoided in the first trimester of pregnancy.

In any case, it is recommended contraception in women already diagnosed with cancer and in treatment. “There are still cases of patients who become pregnant. Although the risks are lower than one might suppose, if we can we should avoid them, "the experts stress.