Breast Cancer and Pregnancy

 The association between breast cancer and pregnancy is defined as detecting breast cancer during pregnancy or within one year after delivery. The diagnosis is often difficult and delayed. It is based on clinical examination, radiological exams (ultrasound and/or RM) and biopsy of the suspected lesion. The staging examinations should be performed only if any change in therapeutic decisions or clinical practice could be made or in the presence of a high risk of distant metastases. The treatment includes surgery, radiotherapy, chemotherapy, hormonal therapy and molecular targeted therapy, and it should be as close as possible with the standard protocols of non-pregnant patients and should be discussed with a multidisciplinary team. It is important to start the treatment as soon as possible, with the exception of term pregnant patients, for whom it can be postponed after delivery. The major fetal complications seem to be related to prematurity, and the type of delivery depends on obstetrics indication. The delivery should be planned at least three weeks after the infusion of chemotherapy, and the treatment generally could be restarted one week after the cesarean section and immediately after a vaginal delivery. The apparent poor outcome in pregnant women can be explained by the delayed diagnosis and/or treatment and the biological characteristics of the tumor (often of high grade and triple negative). Finally, when the treatment is planned, reproductive counseling should always be proposed to young patients immediately after diagnosis in order to plan the best fertility preservation strategies

Keywords: Biopsy, BRCA mutation, Breast cancer, Breastfeeding, Chemotherapy, Delivery, Fertility preservation, Histological type, hormone therapy, Lymph nodes metastases, Magnetic resonance, Mammography, Multidisciplinary team, Pregnancy, Prematurity, Prenatal care, Radiotherapy, Surgery, Survival, Ultrasound.