Breast cancer during pregnancy

The terms gestational breast cancer (GBC) and pregnancy-associated breast cancer are given to breast cancer that occurs during pregnancy and up to one year post-partum. It is an uncommon event, and for even the most experienced clinician, whether oncologist, obstetrician or primary health worker, the complex issues that surround a diagnosis of breast cancer during pregnancy make management difficult. The prognosis overall for women diagnosed with GBC is poor, possibly due to delays in diagnosis. Primary physicians and obstetricians can play an important role in the early detection of GBC by promoting breast awareness in premenopausal women, including women who are pregnant or lactating; and by undertaking prompt and appropriate referral of pregnant and lactating women with breast abnormalities. Even in pregnant or lactating women, clinicians should always investigate a breast abnormality using triple assessment--clinical assessment, imaging and tissue biopsy. Breast cancer during pregnancy requires a multidisciplinary approach to ensure optimal care for both the mother and the baby. Breast cancer management can be adapted to protect the fetus, but this will be dependent on the gestation and disease status at diagnosis. Pregnancy after breast cancer does not appear to affect either cancer prognosis or pregnancy outcome. Obstetricians have a vital role to play in the care of these women by supporting them through their pregnancy, providing reassurance of fetal health and maintaining good communication with their other health providers.