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Published on: October 14, 2015
Breast cancer and pregnancy
Laura Knabben1, Michel D Mueller2
1Department of Obstetrics and Gynaecology, University Hospital of Berne, Effingerstrasse 102, 3010 Berne, Switzerland, Phone: +41 31 632 10 10, Fax: +41 31 632 12 05.
Pregnancy-associated breast cancer (PABC) management requires multidisciplinary care. Diagnosis and treatment should align with non-pregnant guidelines, with chemotherapy possible after the first trimester, while radiotherapy and certain targeted therapies are contraindicated.
Area of Science:
- Oncology
- Reproductive Medicine
- Obstetrics
Background:
- Rising incidence of pregnancy-associated breast cancer (PABC) linked to delayed childbearing and increased breast cancer rates.
- PABC presents unique challenges in diagnosis and treatment due to pregnancy.
- Growing interest in fertility preservation and prognosis for patients diagnosed with breast cancer during or after pregnancy.
Purpose of the Study:
- To provide a comprehensive overview of PABC, including incidence, diagnosis, and treatment.
- To discuss management strategies for breast cancer during pregnancy and pregnancy after breast cancer diagnosis.
- To evaluate the impact of pregnancy on breast cancer prognosis and vice versa.
Main Methods:
- Systematic literature review.
- Analysis of incidence, diagnostic modalities, treatment protocols, and prognostic factors for PABC.
- Review of fertility preservation options and outcomes for pregnancy following breast cancer.
Main Results:
- Ultrasound is the preferred imaging; mammography is safe. Biopsy is crucial for indeterminate sonographic findings.
- Treatment should mirror non-pregnant guidelines; chemotherapy is feasible post-first trimester. Radiotherapy, trastuzumab, and tamoxifen are contraindicated.
- Pregnancy does not negatively affect breast cancer prognosis. Fertility preservation counseling is vital for young patients.
Conclusions:
- Multidisciplinary management is essential for PABC.
- Optimizing obstetric outcomes by avoiding preterm delivery is crucial.
- Further data collection is needed to enhance PABC management strategies.
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