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A look at breast cancer risk in pregnancy | Mammogram Monday

COOPER CITY, Fla. – While pregnancy and breastfeeding may be protective against some forms of breast cancer, women who are older than 30 when they first give birth have a slightly higher risk of breast cancer compared to women who’ve never given birth.

Even before Tracey Hecht and her husband decided to start a family in their 30s she knew she was already at high risk after testing positive for the BRCA 1 gene in her 20s.

“I knew I wanted to breastfeed my kids but I also knew I had the BRCA gene so I wanted to have them pretty close together and then have a prophylactic mastectomy,” Hecht said.

But while breastfeeding her second child, Hecht noticed blood in her milk. Although not a warning sign of cancer, she wasn’t taking any chances and went in for testing.

“I was diagnosed with triple-negative breast cancer,” she said.

Dr. Carmen Calfa with the Sylvester Comprehensive Cancer Center said there’s a lot to learn from Hecht’s story because while pregnancy-related breast cancer is rare, it’s not unheard of.

“By definition, the pregnancy-associated breast cancer includes the cancer that is diagnosed during the pregnancy and in the time that the patient is a year or two post-delivery which includes the lactation period,” Calfa said.

Calfa said cancers during pregnancy may be more advanced because the breast is undergoing many changes and the disease could be overlooked, but new approaches to treatment, such as combing chemotherapy with immunotherapy prior to surgery are improving outcomes.

“So giving the chemotherapy before allows you to assess the response, to minimize the amount of surgery, to minimize the amount of lymph node removal and to be able to analyze their risk of a recurrence or their risk of not being cured through everything you have done at this point,” Calfa said.

Hecht is scheduled to have her last combined chemo and immunotherapy in late October 2020 and surgery to perform a double mastectomy just before Thanksgiving.

“I can sit in bed and eat and just be happy about being cancer-free,” she said with a smile.

Calfa said it’s important for women to realize that they can safely continue breast cancer screening during pregnancy.

She said the risk of radiation to the fetus is negligible and can be further reduced by using special lead shielding.


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