Surgery on breast cancer in pregnancy

Pregnancy-associated breast cancer (PABC) is defined as breast cancer develops either during or within 1 year after pregnancy, it is a rare disease arising in 1:3,000 to 1:10,000 pregnant women. Prognosis of this tumor is influenced by local or systemic treatment, which might be conditioned by gestational age and limited by the concern on potential adverse impact on fetus. The aim of this literature review is to analyze the main topics regarding surgical treatment of patients diagnosed with breast cancer in pregnancy: anesthesia and maternal-fetal monitoring, type of breast surgery, immediate breast reconstruction after radical surgery and management of the axilla. Some important topics remain controversial since the relative rarity of PABC precludes the feasibility of large studies leading to a lack of literature data. Multi-institutional collaboration is warranted to collect women with PABC, in order to best define surgical treatment in view of associated maternal and fetal risks.