Photo by Athena Krueger/Facebook
Athena Krueger, 32, was just a few months pregnant when she was diagnosed with stage 2 invasive ductal carcinoma. The Oak Grove, Minnesota resident was told that she had pregnancy-associated breast cancer, or gestational breast cancer. Doctors say they see more of this type of cancer as women put off pregnancy until later in life.
“It’s not common to have breast cancer during pregnancy, but there are social phenomena today that make that combination more likely than it used to be,” Dr. Marisa Weiss, founder and president of Breastcancer.org and a practicing breast oncologist at Lankenau Medical Center in Wynnewood, Pennsylvania, tells Yahoo Parenting. “The biggest risk factor for breast cancer after being female is increasing age — and getting pregnant later in life creates a higher risk.”
Research shows that pregnancy before age 30 is the most protective against breast cancer. Though it’s not at all rare to have a child after 30 today, historically and evolutionarily it’s an advanced maternal age. Two-thirds of breast cancers are estrogen-positive, meaning they grow during pregnancy, so the older you are during pregnancy, the more chance there is that there are cancer cells present that could respond to the gestational estrogen flood. “When you’re pregnant there’s a strong cocktail of hormones happening,” says Weiss. “Breast cancer cells can marinate in that cocktail and have accelerated growth because they’re so hormonally sensitive.”
Breasts don’t actually finish growing until a woman has completed a full-term pregnancy — the cells mature during gestation. “A full-term pregnancy causes breast cells to get ready to breastfeed,” Weiss explains. “And it’s breastfeeding that makes the cells finish maturing.” The good news is that breastfeeding is protective against breast cancer for every woman, no matter how old she is when she has a child.
Another risk factor for older first-time moms, Weiss notes, is “the preciousness” of the pregnancy. “If it took forever for an older mom to get pregnant, she may not want to give up the pregnancy since she’s worked so hard to bring new life,” she says. But the mom’s life may be threatened by cancer that’s growing faster because of the hormones involved in gestation.
Pregnancy-associated breast cancer, though it may grow rapidly, is not untreatable. “The timing of the cancer diagnosis during pregnancy matters a lot,” says Weiss. Krueger found a lump in her breast in early October, but it was dismissed as a normal tissue change due to her pregnancy. It wasn’t until mid-December, after noticing that the lump was growing and deciding to trust her instincts, that Krueger went back and insisted on another breast exam. The day after Christmas, she got the call from the doctor that began, “I’m so sorry…”
Weiss says that breasts change 100 percent of the time during pregnancy, and nearly 100 percent of those changes are benign. “But a cancer that is already there can get excited and start to grow with pregnancy hormones,” she acknowledges. “It’s not started by the pregnancy but it’s fueled by it.” She notes that malignant breast changes are so uncommon that a healthcare provider may dismiss breast issues when you bring them up. “But if your worries persist, go back,” she advises. “Be more pushy and request to see a breast expert.”
Krueger started chemotherapy at 15 weeks pregnant but doctors saw little response. They decided to induce the birth of her baby girl, named Amari, at 32 weeks in order to pursue more aggressive treatment. Amari was born premature but healthy on May 6th. After having surgery to try to remove the cancer over the summer, Krueger found out through tests that it would return. Her latest blog update reveals that she now has cancer in six lymph nodes “all over” her left side, despite the treatments they’ve tried. She’s looking into integrative treatment now since traditional medicine hasn’t worked, and is concentrating on enjoying each moment with her husband, Ben, and now 6-month-old daughter.
“When you are faced with the fact that there is a chance that your time here on earth is limited and, in fact, may be [up] sooner than you expected, you begin to only focus on the things that matter and all the other distractions subside,” Krueger wrote in a blog post. She alternates between strength, fear, and reverence for life in her online chronicle of this journey, which she says she keeps for Amari.
At times, Krueger writes directly to her daughter: “One of the most precious things that has ever graced my ears is hearing your cry for the first time…There are moments that I wish I could just freeze in time… when all of us are snuggling in bed on a Sunday afternoon or when I’m holding you and you are fighting to not fall asleep, making those cute faces. Pumpkin, I love every minute of being your mommy! There is nothing that makes me want to fight harder.”
A benefit welcoming online donations is being held on Sunday, Nov. 9 in Minneapolis to help the Krueger family pay medical costs that are not covered by insurance.