Q: Should you still be doing self-breast exams while you’re pregnant? If so, how often?
Adashek: Ironically, some studies say that self-breast exams are not shown to be worthwhile; however, other studies show that it is of benefit if a woman does it correctly. It has been found to be especially helpful in minority women, who statistically, do not go in for yearly breast exams as often as non-minority women. While pregnant, self-breast exams have been shown to not be as beneficial—especially towards the end of the pregnancy because of the rapid changes in the milk duct size within the breast.
Q: The breast tissue is different during pregnancy; how will this affect an exam? Is it more difficult to feel a potential lump?
Adashek: Yes. That is why it is very important to have your doctor do a breast exam after delivery, at the 6 week postpartum exam, as well as in the first trimester. As your body prepares for nursing, palpating a breast in the second and third trimester can be difficult because the increasing size of the milk ducts create a lot more lumps.
Q: What do I do if I find a lump?
Adashek: First and foremost: DON’T PANIC!! It is almost always benign. If you find a lump while NOT pregnant, I think that you should wait 2 weeks and then recheck for the lump. Depending on where you are at in the month and when you get your monthly cycle it will most likely just go away on its own. If it is a lump that could be a problem and should be checked out by a doctor, it will still be present after the two weeks. If you find a lump that is concerning while you’re pregnant, again, you don’t have to call your doctor immediately, but make sure you mention it at your next appointment.
Q: Are there any hormones or anything that makes you more likely or less likely to develop breast cancer?
Adashek: The hormones in birth control pills have NOT been conclusively shown to increase the risk of breast cancer. Patients who are in menopause and take estrogen to control the symptoms, MAY have an increased risk of breast cancer; therefore, those patients should talk to their doctor about this.
Q: Do pregnancy hormones make you more susceptible to breast cancer? Or less susceptible for that matter?
Adashek: Actually, the more periods that a woman has in her life, the more likely she may be to develop breast cancer: So, in other words, those patients that started their periods early in life, that have less or no children, or that start menopause later in life are at a higher risk for developing breast cancer.
Q: If you do find a lump, what are your options while pregnant? Can you receive chemotherapy without hurting your baby?
Adashek: It is fairly unusual to find a lump, do a biopsy, surgery and then chemotherapy all while being pregnant. Typically, those patients that get treatment while pregnant are those patients that are already being treated for breast cancer and get pregnant during treatment. There are many chemotherapy agents used for breast cancer that are safe in pregnancy. Those patients must see an MFM specialist (high risk physician). If you find a lump while pregnant, ask your OB/GYN to palpate it. He/she will be better suited to tell whether it is a benign lump or one that is something to be concerned about.
Q: There is some confusion about when to start getting mammograms…before 40 or after 40. What is your recommendation?
Adashek: Well, unfortunately, that answer can be difficult, it would depend on if you have a family history of breast cancer and some other risk factors. Also, these days, there is typically a new study that comes out every few months with a suggestion as to when to start mammograms. In a “low-risk” patient, right now, the recommendations are to start at age 50. Regardless of your age, history, etc, the most important thing you can do is to make sure you see your OB/GYN every year for a breast exam.
Q: How curable is breast cancer?
Adashek: VERY, if found early!
Q: What is the most important thing to know about breast cancer?
Adashek: It is very treatable if it is caught early. And, the best way to detect it early is to do monthly self-breast exams and see your OB/GYN once a year.
Photo by maf04