Breast cancer in pregnancy

Abstract

Malignant neoplasms are the second most common cause of death in women during childbearing age; however, the occurrence of cancer during pregnancy is rare and only 0.02-0.1 percent of all pregnancies is associated with cancer. By increasing the rate of pregnancies in older ages, the incidence of cancer during pregnancy is also being increased. Breast cancer is the second most frequent cancer presenting during pregnancy. Pregnancy-associated breast cancer is defined as breast cancer that is diagnosed during pregnancy, lactation in or at the first postpartum year. Physiologic changes related to the pregnancy and the fetus are the most important diagnostic and therapeutic challenges in pregnant women. The signs and the symptoms of the pregnancy can mask breast cancer in a pregnant woman and lead to late cancer diagnosis. In addition, concerning fetus safety, there are many limitations and contraindications for using diagnostic and therapeutic methods during pregnancy. Due to the absence of major cohort srudies and large randomized trials, many questions regarding the consequences of the diagnosis and treatment of breast cancer in pregnancy remain unanswered. In this article, we review the most important diagnostic and therapeutic challenges and approaches in this group of patients.