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Imaging of pregnancy-associated breast cancer
L Liberman1, C S Giess, D D Dershaw
1Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Purpose:
To assess the use of mammography in diagnosis of pregnancy-associated breast cancer (PABC).
Materials And Methods:
A retrospective review of medical records between 1973 and 1993 was performed in 85 women with breast cancer diagnosed during pregnancy or within 1 year after pregnancy. In 21 of these women, mammography was performed before biopsy; the mammographic findings in this study group, which had 23 cases of invasive carcinoma, were reviewed for signs of malignancy. Breast sonography was performed in six cases in five women; sonographic findings were also reviewed.
Results:
Mammographic findings were present in 18 of 23 cases (78%), including mass (n = 13) (nine cases with calcification), suspicious calcifications (n = 4), and diffusely increased parenchymal density (n = 1). Breast sonography revealed focal solid mass in six of six cases. Axillary lymph node metastases occurred in 15 of 23 cases (65%). Although symptoms occurred before or during pregnancy in 12 cases (52%), PABC was diagnosed after pregnancy in 19 cases (83%).
Conclusion:
PABC is often advanced at diagnosis and associated with poor prognosis. Breast imaging studies usually demonstrate focal findings due to clinically evident PABC.