Breast Cancer during Pregnancy-Current Paradigms, Paths to Explore

Area of Science:

• Oncology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Breast cancer is the most frequent malignancy in pregnant women, with increasing prevalence.
• Pregnancy-associated breast cancer (PABC) presents unique challenges balancing maternal and fetal well-being.
• Limited data exists on the long-term outcomes of in-utero exposure to anti-cancer treatments.

Purpose of the Study:

• To review current evidence on managing breast cancer during pregnancy.
• To outline safe and effective treatment strategies for PABC.
• To highlight the need for further research on long-term effects.

Main Methods:

• Review of existing literature on PABC management.
• Analysis of treatment guidelines for non-pregnant patients applied to pregnancy.
• Assessment of safety and efficacy of different anti-neoplastic modalities during gestation.

Main Results:

• Surgery, including sentinel lymph node biopsy, is feasible across all trimesters.
• Chemotherapy is considered safe in the second and third trimesters, with a recommended 3-week cessation before delivery.
• Radiotherapy is generally contraindicated; hormonal therapy and anti-HER2 agents should be postponed until postpartum.

Conclusions:

• PABC management requires careful risk-benefit assessment for mother and fetus.
• Current treatment approaches prioritize maternal health while minimizing fetal exposure.
• Further large-scale prospective studies are essential to confirm the long-term safety of anti-cancer treatments in pregnancy.