Breast cancer and pregnancy

Sixteen of 194 premenopausal woman with breast cancer developed the disease in association with pregnancy. Eight were pregnant as diagnosis and eight were post-partum. There were significant delays in referral for surgical opinion and treatment among both groups. Two of the eight pregnant patients were diagnosed during the first trimester and one during the second trimester. The rest were at or close to term. Standard surgical therapy without irradiation was employed for early stage disease. Adjuvant chemotherapy posed some problems. One of the patients in the first trimester declined all treatment while the other opted for surgery only until after delivery. There was a favourable obstetrical outcome in all cases and survival for this group of patients is similar to that reported in the medical literature. None of the group had a further pregnancy. The incidence of breast cancer related to pregnancy in this premenopausal group was 8% with 1% occurring in the first trimester. This would mean three or four such cases per annum in Ireland.