Breast cancer with brain metastases in pregnancy

Breast cancer during pregnancy is a therapeutic challenge. Evidence to guide management in metastatic breast cancer during pregnancy is limited, mainly because of a lack of randomized trials. Care needs to be individualized with interdisciplinary collaboration. Various case reports and case series in the literature have shown the safety of some chemotherapeutic agents during the second and third trimesters of pregnancy. Surgery is also safe after the first trimester. Brain metastasis from breast cancer during pregnancy is an especially challenging clinical situation and has been reported only in one other case. We present the case of a young woman with HER2/neu overexpressed inflammatory breast cancer who became pregnant while on treatment, refused termination of pregnancy, and developed brain metastasis during the second trimester of pregnancy, posing a management dilemma.