Among the many changes your body goes through when you're pregnant are changes in your breasts. Hormonal changes during pregnancy and lactation increase the breasts' volume and firmness, making it harder to detect breast masses.

During pregnancy your breasts will enlarge, feel more lumpy and bumpy, hurt, and have other unusual symptoms. Don't ignore these symptoms and assume that they are all related to your pregnancy. Show your doctor what you are feeling so that a clinical breast exam can verify all is well.

If an abnormality is found that requires immediate investigation and treatment, concerns about the safety of the developing fetus can complicate treatment decisions. A study published in the April 2005 issue of the journal Radiology reports that ultrasound provides a safe and accurate method of detecting breast cancers in pregnant women, as well as in assessing response to chemotherapy in women who undergo chemo during pregnancy.

Investigators at the M. D. Anderson Cancer Center recently studied the largest group of women who were both diagnosed and treated for breast cancer during pregnancy.

Most of the women in the study were found to have locally advanced breast cancer. Because of the advanced stage of the cancers in this study, 16 patients (70 percent) underwent anthracycline-based chemotherapy in their second and third trimesters in an attempt to shrink the tumors.

This type of chemotherapy poses minimal risk to the developing fetus and is the preferred method of treatment for pregnant women, in whom radiation treatments and surgery are usually avoided. Twelve of the 16 women underwent ultrasound to assess their tumors' response to chemotherapy. The researchers found that ultrasound provided an accurate depiction of treatment response in all 12 patients.

Women can be and are diagnosed with breast cancer during their pregnancy. It's a frightening thing to think about, and perhaps for this reason some women delay reporting breast changes until after the pregnancy is over and symptoms persist. Now, though, research tells us that they needn't wait to be diagnosed and get any necessary treatment.