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Breast cancer during pregnancy

Publication at First Faculty of Medicine, Faculty of Physical Education and Sport |
2014

Abstract

Breast cancer belongs in most common malignant diseases diagnosed during pregnancy. Incidence in Czech Republic is estimated to 10-30 in 100 000 pregnancies, including pregnancy associated breast cancer (breast cancer diagnosed within one year after delivery).

Breast cancer is often diagnosed at advanced stages because of immitation of classical signs with normal changes in pregnant or lactating breast. Therefore each pregnant women should underwent examination of breasts with diagnose of pregnancy.

The most appropriate imaging examination is ultra-sonography, mammography can be used at first end second trimester with proper shielding of pregnant uterus. Use of scintigraphy in staging can be replaced by whole body MRI.

Treatment should be planned by multidisciplinary team, including oncologist, radiotherapist, ob-gyn specialist, neonatologist, expectant mother and father of unborn child. All treatment modalities can be used - surgical approach, chemotherapy and in rare cases radiotherapy (by AAPM standards).

Currently, the diagnosis of malignant disease during pregnancy is no longer automatic indication for termination of pregancy. Primary target of our treatment efforts is to avoid of preterm birth in lower gestations weeks, therefore higher risk of neonatal morbidity and mortality.

Prognosis of pregnant patients with breast cancer is not different from nonpregnant.