NEW YORK — As more women delay pregnancy into their 30s and 40s, physicians are seeing more pregnancy-associated breast cancers, experts noted at a New York University cancer symposium.
This trend may particularly impact women who carry BRCA1 and BRCA2 genetic mutations, since cancers develop in these women at significantly younger ages than in noncarriers, and some studies have indicated that mutation carriers are more likely to develop cancer during pregnancy.
“This underscores the importance of obstetricians' taking a good family history in their patients who are pregnant or planning to become pregnant,” said Ellen Warner, M.D., of the University of Toronto, who participated in a panel discussion.
“Women who carry a genetic mutation may need a baseline MRI to screen them for occult or early cancer prior to becoming pregnant, along with very close follow-up,” Dr. Warner said during the meeting, which was also sponsored by the Lynne Cohen Foundation for Ovarian Cancer Research.
“We can't say that we're going to save lives with certainty. Just as with other types of surveillance, this is based mostly on expert opinion,” said Elsa Reich, a genetic counselor at the university. “But I feel really strongly that obstetricians should be vigilant about evaluating family history. If a young woman has a mother who died of breast cancer at age 40, she should at least be advised of her increased risk and given the option of consulting a genetic counselor prior to pregnancy.”
Breast cancer is the most common cancer in pregnant and postpartum women, occurring in 1 in 3,000 women. The American College of Obstetricians and Gynecologists hasn't issued recommendations about screening in women with BRCA1 and BRCA2 mutations who plan to become pregnant, although it has noted that women whose first pregnancies occur after age 30 are at some degree of increased risk.