Breast cancer during pregnancy – the risks of a missed or delayed diagnosis

Posted: 15/12/2023

Breast cancer during pregnancy is relatively rare – occurring in approximately one in every 3,000 pregnancies – and so many GPs may not have come across it. This means that some women are reporting breast lumps and being incorrectly reassured that they are harmless and are caused by pregnancy hormones. 

This can tragically lead to a delay in diagnosis, which can have life-changing consequences. The sooner cancer is diagnosed, the better the chance of surviving it. Breast cancers missed in pregnant women, due to the signs being dismissed as pregnancy-related, are, sadly, costing lives. As it occurs most often in women aged 32 to 38 years, and with many women choosing to delay having children, it is likely that the number of new cases of breast cancer during pregnancy will only increase.

‘I skipped out of the GP surgery feeling hugely relieved that I had nothing to worry about and could get on with my pregnancy and look forward to the arrival of my baby’ is sadly a typical story from a woman in this situation. GPs should not be blind to the possibility of cancer. They should effectively overlook that the woman is pregnant and consider whether she requires a 14 day cancer referral and if so, make those arrangements. If her results are then clear, then it may be that the lump is innocuous and pregnancy related. The fact of the pregnancy should not preclude a proper investigation and cancer diagnosis consideration. Hard breast lumps that persist are more likely to be cancerous and hormone-related lumps are usually soft and disappear quite quickly. 

It is difficult for a woman in her first pregnancy to know what is usual for her or not. However, women often get a feeling when something isn’t right or normal for them. A change in one breast and not both may indicate something that needs checking out. Women shouldn’t feel reluctant to see their GP and if they remain worried, to ask or ask again for a referral for a breast cancer investigation for full peace of mind. 

Pregnant women can safely receive treatment for breast cancer, although the types of treatment used and the timing of treatment might be affected by the pregnancy. The treatment recommendations for pregnant women are likely to depend on the size and location of the tumour, and how far through pregnancy the woman is. Chemotherapy may be delayed until after the first trimester for example, as chemotherapy agents are contraindicated in early pregnancy. If breast cancer is diagnosed very late into the pregnancy, it may be advisable to delay CT scanning until after the woman has given birth. 

Case study – what happens when a diagnosis is delayed

In the case of NT and PT v Shrewsbury and Telford Hospital NHS Trust, the family of a deceased woman brought a claim for delayed diagnosis of breast cancer following a miscarriage. The deceased woman had felt a small breast lump but was reassured that it was nothing to worry about and led to believe that it was due to her pregnancy. However, the lump continued to grow and five months later a biopsy revealed it to be a stage 3 breast cancer. The woman underwent a mastectomy to remove her breast, chemotherapy, radiotherapy and hormone therapy, but sadly it was too late as the cancer spread firstly to her spine, and then to her lungs. 

The claim was based on alleged hospital negligence in not investigating thoroughly enough, which would have resulted in a diagnosis of cancer and that, on the balance of probability, if cancer had been diagnosed and treated earlier, the woman would not have developed metastases (spread of the cancer) and would have survived. The defendant NHS trust admitted breach of duty but denied that there had been any effect on the treatment needed or the prognosis, and argued that the woman would have died at the same time in any event. 

The NHS trust also sought to argue that the claim shouldn’t proceed due to the passage of time, as it was brought by the deceased’s family more than three years after the treatment in question. This argument was defeated, as the deceased only had knowledge of the potential negligence when she finally received her cancer diagnosis. Despite the denial of causation, the claim was settled out of court with the deceased’s family receiving £250,000 in damages.

Our clinical negligence specialist solicitors have expertise in investigating cases relating to delayed diagnoses of cancer of all types. We always have a client-friendly approach so please do contact us if you have concerns regarding your oncology treatment and we will advise you of your options and how we can help.

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