NYU Langone expert treats 32-year-old Westchester mother for breast cancer while pregnant

Christina, a former teacher, was 32 years old when she found out she was pregnant with her second child. Two weeks later, she received the shocking news that she had breast cancer.

Christina's journey began when she felt a lump in her breast during a self-examination. She realized something was wrong and went to the doctor to get it checked out. From there, she consulted her gynecologist, who was supportive and suggested she get a mammogram. Mammography is generally recommended for Breast cancer screening Women aged 40 and older have the option of starting earlier if they have a family history of breast cancer or have certain genetic mutations that increase their risk of breast cancer.

But Christina knew her body, knew what was right and what was wrong, and advocated for her health. She underwent an imaging test biopsy It was revealed that she had breast cancer. Her GP recognized that she needed a dedicated team of professionals to help her overcome this diagnosis during her pregnancy and give her the best chance of recovery.

Breast cancer can be treated during pregnancy, but treatment is especially complicated during early pregnancy. After being told by other medical providers that the cancer could not be treated without terminating the pregnancy, Christina was advised to seek out breast oncologist Mary L. Gemignani, M.P.H., and medical oncologist Elizabeth Komen, M.D., at New York University Langone Perlmutter Cancer Center.

There, a multidisciplinary team of doctors accepted Christina as a patient and developed a care plan, although they explained that she would need to wait until after the first trimester. Concerns about infertility and pregnancy are becoming more common among patients diagnosed with breast cancerBecause doctors are seeing more cases among young women. Her doctors discussed all options and factors related to cancer treatment, how to avoid harm to the baby, and how to maximize outcomes for both her and her baby, and developed a treatment plan.

“My husband and I turned to NYU Langone. They welcomed us, made us feel comfortable, and helped us improve diagnosis and treatment,” Christina said. “This was a team effort. It was never based on one doctor's opinion, but on my needs as a patient.”

Treatment of breast cancer in pregnant patients requires close interdisciplinary collaboration. In this case, the diagnosis was made during the first trimester, when chemotherapy is generally avoided. The maternal-fetal medical team worked with the oncology department to begin surgery and allow her to move into the second trimester, when it was safe to begin chemotherapy.

Cancer during pregnancy is not common, but as more women delay fertility and childbearing for personal or professional reasons, cancer may be diagnosed before childbirth is complete. Additionally, doctors are seeing women who are diagnosed with breast cancer at a younger age.

The median age for breast cancer is 62 years. Over the past 20 years, breast cancer diagnoses at ages 20 to 29 and 30 to 39 have increased. At NYU Langone, we are committed to providing young cancer patients with personalized care that addresses their individual needs and provides them with the best quality of life possible. Survivorship has evolved into a truly holistic and personal experience, and our programs honor that. ”

Mary L. Gemignani, MD, MPH, Chief of Breast Surgery and Director of the Early Onset Cancer Program at Perlmutter Cancer Center

At the end of her first trimester, after many consultations and tests, Christina underwent a mastectomy to remove the cancer. After recovering from surgery, she continued to undergo chemotherapy. All the while, her team worked together to ensure her health and the health of her pregnancy.

“Christina's story is a reminder that interdisciplinary cancer care is so important,” said Dr. Komen, co-director of the NYU Langone Mignone Women's Health Collaborative. “Here at Perlmutter Cancer Center, we are uniquely equipped to care for patients with complex cases like hers, offering a wide range of experts to treat the patient, not just the disease.”

Perlmutter Cancer Center takes a strong multidisciplinary approach to cancer treatment, with physicians from a variety of specialties presenting regularly and in real time. Because the health of her pregnancy required regular monitoring, Dr. Justin S. Brandt, M.D., director of maternal-fetal medicine, contacted Dr. Komen several times to discuss continuing or continuing chemotherapy at various times. This multidisciplinary approach allowed for seamless care based on Christina's needs.

It is natural to have concerns about both surgery and chemotherapy during pregnancy. Dr. Brandt's team at Maternal and Child Health Services leveraged data from cancer registries during pregnancy and experience at her own institution to provide evidence-based guidance. Intensive maternal and fetal monitoring was essential to support treatment while maintaining a healthy pregnancy. It was also important to time Christina's baby to avoid premature birth. They consulted and collaborated with the entire multidisciplinary team and delivery occurred at 39 weeks, which is optimal for fetal maturation. Christina gave birth safely.

“We do a lot of special monitoring for pregnant patients who have cancer during pregnancy,” Dr. Brandt said. “In addition to routine care, we closely monitor the fetus's growth with monthly ultrasounds. At 32 weeks, we begin a biophysical profile that evaluates the fetus's health weekly.”

Christina credits her positive attitude during treatment to her strong support system at home, including her husband Jeremy and family and friends, many of whom visited with her, helped care for their 4-year-old son, and provided emotional support throughout the process.

Christina and Jeremy gave birth to a baby girl, Isabella, at the end of September and are currently completing treatment. Her prognosis is good and she continues to work closely with her doctors to become cancer-free.