Breast cancer in pregnancy - a dreaded diagnosis

The journey to having a healthy baby can be difficult – and for Melbourne mum Rocio Albornoz, it was longer and more stressful than most.

The 39-year-old, known as Rosie, was diagnosed with breast cancer halfway through her pregnancy.

Having already survived cancer once before, she had been dreading that it would return.

"I had cervical cancer about 10 years ago that was detected very early," she said. "When you have cancer once, you are forever scared of getting cancer again."

At 20 weeks pregnant, Rosie consulted her obstetrician at Epworth Freemasons hospital, Dr Scott Shemer, who arranged urgent scans and tests.

"When I received my diagnosis, my doctors said, 'Let's start doing something about it right away'," Rosie said.

"It was so fast, but they sat with me for an hour going through everything and answering all my questions.

"I was pregnant and tired, and it was overwhelming, but my doctors were right there with me."

Dr Shemer worked with a team of Epworth Freemasons cancer specialists as treatment for Rosie's cancer started, adapting chemotherapy to ensure the safety of both mother and baby.

Months later, Rosie delivered a healthy son, Liam, at Epworth Freemasons' maternity unit, with husband Oliver by her side – and daughter Ella excited to become a big sister.

"I remember the moment of delivering Liam and you just feel so happy for Rosie and Ollie. You feel proud to have been a part of it," Dr Shemer said.

"It's profoundly rewarding to see a woman who's been through so much take home a healthy baby. I think it's a relief for everyone involved to know that he's here safely and now Rosie can continue her treatment."

Breast cancer surgeon Dr Peter Newton said Rosie still had a journey ahead of her.

"When I saw Rosie's symptoms, there were red flags immediately. You never stop until you are sure it is not cancer," he said.

"It isn't common to diagnose breast cancer during pregnancy, but those who are diagnosed tend to be at a later stage, as the symptoms are often attributed to pregnancy and cancer is the last thing on your mind."

Rosie had four sessions of chemotherapy before treatment was paused in her last trimester.

She recently restarted treatment under the care of oncologist Dr James McCracken and will have a double mastectomy and reconstruction surgery later this year.

"Rosie has been incredibly brave and courageous," Dr McCracken said.

"Throughout everything, she has always said, 'What's next?'.

"In terms of treatment options, once babies are outside the first trimester chemotherapy is reasonably safe.

"We finish the round of chemotherapy significantly before the due date and then resume treatment once the baby is delivered.

"When providing treatment during pregnancy, a mother's health and wellness is integral – for her sake and the sake of the baby. You are always aware you're treating two patients."

Dr Shemer said pregnancy could result in a range of "strange and wonderful" symptoms that were completely normal.

"However, if any of those symptoms are causing concern, Rosie's experience highlights the importance of trusting your instincts and seeking medical advice," he said.

"There are many women who just put everything down to 'it must be pregnancy'. But if there's a symptom that doesn't seem right, it's worth raising it with your obstetrician."

Epworth Freemasons' Executive General Manager, Jo Goodridge, said all the services Rosie needed for her care were available under one roof.

"Including psychology, physiotherapy and gestational diabetes services as well as her obstetrics and cancer care," she said.

"The hospital has a dedicated maternity hub that supports patients before, during and after pregnancy.

"Rosie's story is a powerful example of the network of specialists our patients have access to, in one place. The coordination between our specialists and fast referrals means we can provide seamless care for our patients."

Dr Shemer said every specialist Rosie needed was 'a 20-metre walk or elevator ride' within Epworth Freemasons.

"When you are contending with the stress and worry of a profound diagnosis like breast cancer in pregnancy, you shouldn't have to focus on the logistics of your care," he said.

"That should be taken care of by the team looking after you – and for that to be accessible and under one roof is testament to the high level of care that Epworth is able to provide."

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