Pregnancy & Breast Cancer

Pregnancy & Breast Cancer

Diagnosed Whilst Pregnant

WebMD states that “It doesn’t happen often, but sometimes mothers-to-be have breast cancer. Getting pregnant doesn’t cause the cancer, although the changes in hormones from the pregnancy can make the disease grow faster”.  This was certainly the case for me.

As I mentioned in My Story, I was diagnosed with breast cancer when I was 8 months pregnant.  I found the lump when I was 7 months pregnant and just thought it was something to do with the pregnancy.  After an ultrasound and biopsy I found out that it was in fact a baddie.

My immediate concern was for my little bundle in my belly, Sophia.  The doctors reassured me that everything was ok with Sophia (the baddie wasn’t affecting her in any way) and that she was completely happy in my tummy; thank goodness!

I had an extra ultrasound just to check in on Sophia and make sure she was ok.  It was really comforting to see her although she still looked like an alien LOL!

Evicting Sophia

Being diagnosed when I was pregnant definitely added a couple of extra complications into how to treat the cancer.  First of all, I had originally planned to use a midwife for my delivery; however, I needed to switch over to an OBGYN quickly as I was now a “high-risk” pregnancy and would need to be induced.

The second issue was that Sophia needed to be evicted from her current home early so that I could have surgery ASAP. 

In an ideal world, the surgeon would have liked Sophia induced and delivered immediately following my diagnosis (so 6+ weeks early).  I wasn’t happy about kicking Sophia out so soon though as I anticipated that I would have enough to deal with having a newborn baby and going through breast cancer surgery etc. without Sophia being in the neonatal unit for being too early.  After a discussion with my surgeon, he was happy to let Sophia stay in my belly for as long as I was waiting for the gene test results, which bought me an extra 4 weeks.  My OBGYN was really great and was happy for Sophia to stay put until just a few days before my scheduled surgery – this meant that she was only 2 weeks early and didn’t have to spend any extra time in the hospital…yippee.  This decision could have back-fired had I needed to have a C-section or had complications from the delivery but everything went smoothly so my surgery date wasn’t affected.

In a way, I was lucky that I was diagnosed towards the end of my pregnancy as it meant that I was able to wait until Sophia was at full term before being induced.  Had I been diagnosed very early in my pregnancy then my options would have been completely different – I may have even had to have the breast surgery whilst I was pregnant which wouldn’t have been ideal.

Gene Test

A few days after I was diagnosed, I had a gene test done to understand whether my cancer was hereditary or not.  The main genes tested for were BRCA 1 and BRCA 2 mutations.  Luckily, I was negative for the BRCA gene mutations which was absolutely great news as this meant that I hadn’t passed the mutation onto Sophia.

Induced & Surgery

I was induced 2 weeks before Sophia’s due date and all went well (once I had the magic pain relief anyway…LOL!).  I now had my special bundle in my arms and she was perfectly healthy.

I was scheduled to have surgery a couple of days after Sophia was born, but this ended up being delayed by a week as my gene test results weren’t back in time.  The extra week was perfect for me though as I got to spend more time with Sophia and I also got a chance to get my mastitis under control.

My surgery went well and I healed up nicely.  I was supposed to refrain from picking up Sophia for 1-2 weeks to give my stitches a chance to heal but I challenge anyone to resist picking up their little newborn for such a long time.  I obeyed the doctor’s orders for the day of surgery – Simon just popped Sophia on top of me for a snuggle that evening.  After the first evening I couldn’t help myself and completely didn’t abide by this suggestion.  I don’t recommend not following the doctors suggestions; however, I felt like I was able to hold Sophia as she was so small and light.

As a side note, you will likely be recommended to wear non-wire bras following your surgery.  I would highly recommend Lululemon’s high-necked soft sports bras.  I lived in these after my surgery and throughout my treatment – they are super comfy and didn’t irritate my surgery wounds etc.  The high-necked sports bras also had the added advantage of covering the port….bonus!

Breast Feeding Options

Before I was diagnosed, I was really hoping to be able to breast feed Sophia.  This became a big decision for me in relation to my surgery options of lumpectomy vs. full mastectomy.  As my gene tests were negative for the BRCA gene mutations, this ruled out the requirement for a full mastectomy which increased my options for being able to breast feed.  I later opted out of the optional mastectomy.

I chose to breast feed Sophia immediately once she was born.  I was luckily able to breast feed for the first 5 days which enabled me to provide Sophia with the colostrum which is the important part of breast milk for newborn babies.  After this, I developed mastitis and had to go on antibiotics to reduce the swelling in my breasts and also get rid of the infection.  My lumpectomy surgery being delayed turned out to be a blessing as I needed the extra week for the antibiotics to work their magic and get everything under control so that I could have the breast surgery as planned (otherwise there might have been a milk explosion during the surgery LOL!).

Although I wasn’t able to breast feed beyond the first 5 days, I was super lucky and obtained donated breast milk from my local breast bank, NorthernStar Mothers Milk Bank.  Ordinarily, the breast bank milk is intended for premature babies where the mothers are unable to breast feed due to the baby being too premature.  My local breast bank made an exception for my situation, as I intended to breast feed but was now unable to, and generously donated 3 months supply of milk for using on Sophia.  My husband and I chose to give Sophia a couple of bottles of breast milk each day and supplement the extra feeds with formula so that we could spread out the breast milk bottles for longer than 3 months.

After I had the mastitis under control, I had my lumpectomy surgery.  Once I had recovered from the lumpectomy surgery, I was no longer able to breast feed or pump milk for Sophia as it had been too long since I had last tried (due to the mastitis and then the surgery).

Not being able to breast feed was initially upsetting news for me as I felt like I was not doing the best thing for Sophia.  As a side note, there is a lot of pressure out there for mothers to breast feed.  I was able to talk with a lot of doctors, including a breast-feeding specialist, to understand all of my options before Sophia was born.  My options were basically that I couldn’t/shouldn’t breast feed.  I feel like I provided the best start to Sophia that I could provide; with me providing the colostrum and then the breast bank milk covering the other essential nutrients.  Nevertheless,  I still felt the pressure and judgement from other people for not breast feeding.  I even felt this pressure from doctors and nurses who knew that I had breast cancer and should therefore have known that breast feeding likely wasn’t an option for me.  If you are in a similar position to me, I am sure that you will also unfortunately feel this pressure….just try your best to ignore this pressure and know that I fed Sophia formula and she has turned out just perfectly.

Starting Treatment

If you are lucky enough to be able to continue to breast feed then please ask your oncologist about the suitability of breast feeding whilst receiving chemotherapy, radiation and any other treatments.  You will likely have to wait a certain period after each treatment for any adverse effects of the treatment to leave your body before you can resume breast feeding.

Once I started chemo, I would get a lot of sympathetic looks (be prepared for this) from people at the hospital when they realized that I had breast cancer, as I was really young for having breast cancer, and also a newborn baby (double whammy).  The sympathetic looks did bother me a little but I tried not to think too much about it though; I was just trying my best to get through treatment and juggle being a new mum at the same time. 

Whilst it wasn’t ideal timing, in a way it was easier to deal with recovering from the surgery and chemo etc. whilst Sophia was so young as she was so small and slept through most of it.  Had I been diagnosed now that Sophia is 1 and super active, that would have been a whole other level of exhaustion to deal with.

Support

It’s not easy to juggle treatment with a new born baby but Sophia was a great distraction from everything and an amazing snuggler.  I also had really great supportive family and friends to help me through it.  My family all live back in the UK (except for my sister-in-law who is also in Canada), but they all took time out of their busy lives to come over and help Simon and I out which was just amazing.  Our friends were also incredible and organized a “meal-train” where someone brought dinner for us every other night so that we didn’t have to think about grocery shopping and cooking…amazing!  

I also can’t thank Simon enough for getting me through this journey – his love and support is amazing and I couldn’t have done this without him.

I should also give a little shout-out to our little puppy Bertina; her endless love and cuddles always brightens up my day.

Pregnancy After Breast Cancer

I always thought that I would like 1 or 2 bambinos (not including Bertie LOL!) when the time was right.  I feel very fortunate and blessed to have Sophia, but I would love to be able to give her a sibling to grow up with.

Whilst it is possible for some women to get pregnant after having breast cancer treatment, there have not been very many medical studies done to understand how becoming pregnant after treatment may affect your chances of the cancer returning.

I was advised that, as a minimum, I would be required to wait as follows for each treatment to leave my system and not affect any potential bambino:

  • Chemo – Wait couple of days (maybe increase this to be on the safe side)
  • Tamoxifen – Wait 3 months
  • Herceptin – Wait 9 months

I have finished up all of my surgeries (including the port removal), chemotherapy, radiation and Herceptin treatments now.  The only on-going treatment for me is Tamoxifen.  I have been recommended to take tamoxifen for 10 years as studies now show that this is more beneficial for the cancer not returning over taking the tablets for 5 years. 

As I mention in my Tamoxifen page, I don’t feel 100% myself on the Tamoxifen tablets so I’m not sure if I am going to follow through with the suggestion to take them for 10 years.  Right now, I am striving to just hit the 1 year mark and will take it from there.

As the Tamoxifen would need to clear my system for at least 3 months, I would need to stop taking Tamoxifen to try and expand my family.  I also am not sure if I would even be able to become pregnant again as I don’t fully know how the treatment has affected my body or my fertility.  My periods are now very erratic and almost non-existent.  It would be interesting to see if my periods return to normal after stopping Tamoxifen, but right now I don’t know.

It would be very risky for me to try and get pregnant again as my tumour was hormone positive and therefore loved the extra hormones my body produced from being pregnant, which is why I noticed the lump in the first place.  As with any treatment or decision though, I ultimately need to weigh up everything and decide what is best for me and my quality of life.

I am officially 6 months cancer free (YIPPEEEEEEEE!) so I have been discharged from my chemo oncologist.  I will be meeting with my follow-up oncologist in 6 months and will be very interested to hear what she thinks about becoming pregnant after treatment.  I have read about some people coming off Tamoxifen, getting pregnant, and then re-starting the Tamoxifen after the baby is born.  Hopefully this will be me if I decide to try and have another bambino, although I might not re-start Tamoxifen.

There seems to be contradictory information out there about the ability to breast feed whilst on Tamoxifen.  This will be something that I explore further if I am lucky enough to become pregnant again.

Useful Websites on Pregnancy and Breast Cancer

Here are some websites that I found that you may find useful:

Xo

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