When a perfectly healthy, pregnant, 29-year-old gets diagnosed with breast cancer, people have a lot of questions...
Q: Do you know if you have the BRCA1 or BRCA2 gene that is know to cause some breast cancers in young women?
A: I do not have the BRCA1 or BRCA2 gene.
Q: Do you have a family history of breast cancer?
A: Not really. Both of my Dad's grandmother's had breast cancer in their 70s and survived. My maternal grandmother got ovarian cancer in her 60s and died of it (ovarian and breast cancer are related). So I'm really an outlier. I hope this means my daughter will never have to experience this horrible disease.
Q: How are pregnancy and breast cancer related?
A: Pregnancy-associated breast cancer (PABC) occurs is 1/3000 pregnant women. Young patients with PABC do not have worse prognosis compared with those with non-PABC. Some doctors think that pregnancy hormones can fuel the growth of breast cancer, but the exact relationship is not known.
Q: Can you seriously do chemo while pregnant? How does that even make sense?
A: Yes. Many of the chemo drugs do not cross the placenta due the molecular size of them. News story here. Medical article here. I've met dozens of women (online and in person) who've had chemo (most typically Adriamycin and Cytoxin) while pregnant and have perfectly healthy, vibrant children.
Q: What is the survival rate for your type of breast cancer?
A: At diagnosis based on my type and stage we estimate it be around a 70% chance (some recent studies even put the odds as high 80%) as of disease-free survival after 5 years. If I'm cancer free for 5 years, it's unlikely this cancer will ever return.
Q: Does a pathological complete response change your survival odds?
A: Studies show that those that have a complete response to chemo have between an 85%-95% disease-free survival rate. So yes, a complete response is a positive prognostic indicator.
Q: Are you glad you did neo-adjunctive chemotherapy?
A: Yes, yes, YES. It was the recommendation of my doctors for my particular stage and type of breast cancer (triple negative). It was great because my mastectomy after chemo showed that there was no living cancer cells left in the breast or lymph nodes which means the chemo worked. Also, I didn't have to have surgery while pregnant.