Managing pregnancy-associated breast cancer: A practical approach

Pregnancy-Associated Breast Cancer (PABC) is a rare but complex condition that presents both professional and ethical challenges. Diagnosis is often delayed due to breast changes associated with pregnancy and puerperium, which can mask malignant findings. Management requires a multidisciplinary approach that carefully balances maternal and fetal risks. Chemotherapy is generally reserved for the second and third trimesters to avoid teratogenicity, with anthracyclines being the most well-studied and safest agents in this setting. Surgical decisions are influenced by factors such as cancer stage, gestational age, and the timing of potential radiation therapy. Notably, radiation therapy, endocrine therapy, and most targeted therapies are contraindicated during pregnancy due to potential harm to the fetus. Comprehensive care should include robust social and mental health support for the mother and her family to help navigate the physical and emotional challenges during this period.