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Gestational breast cancer

T H Samuels1, F F Liu, M Yaffe

  • 1Department of Oncologic Imaging, Princess Margaret Hospital, Toronto, Ont.

Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes
|June 26, 1998
PubMed
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Breast cancer during pregnancy is rare but requires prompt imaging. Ultrasonography is recommended for initial assessment of breast masses in pregnant or lactating individuals, followed by mammography if cancer is suspected.

Area of Science:

  • Oncology
  • Radiology
  • Obstetrics & Gynecology

Background:

  • Gestational breast cancer, occurring during pregnancy or lactation, is uncommon.
  • Diagnosis can be delayed due to clinician reluctance in utilizing breast imaging techniques.

Purpose of the Study:

  • To investigate the challenges and diagnostic utility of breast imaging in gestational breast cancer.
  • To evaluate the effectiveness of mammography and ultrasonography in detecting breast cancer during pregnancy and lactation.

Main Methods:

  • Retrospective review of 19 patients diagnosed with breast cancer during pregnancy, lactation, or within one year postpartum.
  • Analysis of mammograms and breast ultrasonograms for 10 patients referred for adjuvant therapy.

Main Results:

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  • All patients presented with palpable tumors; advanced stages (T2 or higher) and positive axillary nodes were common.
  • Diagnostic delays ranged from 2 to 16 months in 11 patients.
  • Mammography detected cancers in 5 of 8 reviewed cases, while ultrasonography identified solid masses, sometimes mimicking benign lesions.

Conclusions:

  • Radiologists should consider gestational breast cancer in the differential diagnosis of breast masses during pregnancy or lactation.
  • Ultrasonography is the preferred initial imaging modality; mammography with abdominal shielding is advised if cancer is suspected.
  • Integrating clinical, mammographic, and sonographic findings is crucial for accurate diagnosis.