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Breast disease complicating pregnancy

J I Sorosky1, C E Scott-Conner

  • 1Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, USA.

Obstetrics and Gynecology Clinics of North America
|June 18, 1998
PubMed
Summary

Pregnancy and breast cancer (PABC) is rare, often presenting as painless masses detected by self-exams. Treatment focuses on the cancer while allowing the pregnancy to continue, with no adverse effects on future pregnancies.

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Area of Science:

  • Oncology
  • Obstetrics & Gynecology
  • Radiology

Background:

  • Pregnancy-associated breast cancer (PABC) is uncommon, affecting approximately 1 in 1000 pregnancies.
  • Breast changes during pregnancy can impede clinical and mammographic detection of cancerous lesions.
  • PABC often presents as advanced disease with larger tumors and higher rates of nodal involvement.

Purpose of the Study:

  • To summarize the clinical presentation, diagnosis, and management of pregnancy-associated breast cancer.
  • To discuss the challenges in diagnosing breast masses during pregnancy.
  • To review treatment principles and outcomes for PABC.

Main Methods:

  • Review of clinical presentation and diagnostic challenges in PABC.
  • Emphasis on breast self-examination (BSE) for early detection.
  • Discussion of fine-needle aspiration cytology (FNAC) as the primary diagnostic tool.
  • Analysis of treatment strategies and impact on pregnancy and future pregnancies.

Main Results:

  • Most PABC cases are detected as painless masses, with 90% identified through BSE.
  • Imaging modalities have limited roles due to pregnancy-related breast changes.
  • Fine-needle aspiration cytology is the preferred initial diagnostic procedure.
  • Therapeutic abortion does not improve survival; treatment focuses on the cancer with pregnancy continuation.
  • Subsequent pregnancies show no adverse effects, even with positive nodes or early timing post-treatment.

Conclusions:

  • Pregnancy-associated breast cancer requires careful evaluation, with BSE and FNAC being crucial.
  • Management prioritizes cancer treatment while allowing the pregnancy to proceed.
  • PABC diagnosis and treatment do not negatively impact future pregnancy outcomes.

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