Pregnancy-associated breast cancer: a case report and literature review

Authors

  • Sarah Van Der Hock Faculty of Medicine and Science, The University of Melbourne, Victoria, Australia https://orcid.org/0009-0001-6109-4288
  • Alekhya Chintamani Department of Obstetrics and Gynaecology, New South Wales, Australia
  • Gabriella Bulloch Faculty of Medicine and Science, The University of Melbourne, Victoria, Australia https://orcid.org/0000-0001-9901-7088
  • Ishith Seth Faculty of Medicine and Science, The University of Melbourne, Victoria, Australia; Department of Surgery, Peninsula Health, Victoria, Australia https://orcid.org/0000-0001-5444-8925
  • Nita Dhupar Department of Obstetrics and Gynaecology, New South Wales, Australia

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232968

Keywords:

Breast cancer, Pregnancy, Chemotherapy, PABC

Abstract

Pregnancy-associated breast cancer (PABC) is a rare, yet significant clinical entity which presents itself during pregnancy or within one year postpartum. This case report and literature review discusses the case of a 33-year-old G1P0 woman diagnosed with PABC at 38 weeks’ gestation with an uncomplicated pregnancy and no significant risk factors. Fine needle aspiration revealed a left-sided metaplastic grade 3 invasive ductal carcinoma with heterogeneous mesenchymal differentiation and focal ductal carcinoma in situ, and an uncomplicated nipple-sparing mastectomy was undertaken at three weeks’ post-partum. This case report emphasises the need for early diagnosis and the importance of screening for breast cancer during pregnancy, and advocates for a low threshold to screen for PABC in all pregnancies. The literature review also provides updated insights into the presentation, diagnosis, and management of PABC. We explore the diagnostic challenges associated with PABC, including physiological changes in breast tissue during pregnancy, limitations of imaging modalities, and the importance of considering PABC as a differential diagnosis.

References

Martínez MT, Bermejo B, Hernando C, Gambardella V, Cejalvo JM, Lluch A. Breast cancer in pregnant patients: A review of the literature. Eur J Obstet Gynecol Reprod Biol. 2018;230:222-7.

Loibl S, Han SN, von Minckwitz G, Bontenbal M, Ring A, Giermek J, et al. Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol. 2012;13(9):887-96.

Amant F, von Minckwitz G, Han SN, Bontenbal M, Ring AE, Giermek J, et al. Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study. J Clin Oncol. 2013;31(20):2532-9.

Cancello G, Maisonneuve P, Rotmensz N, Viale G, Mastropasqua M, Pruneri G, et al. Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (< 35 years) with operable breast cancer. Ann Oncol. 2010;21(10):1974-81.

Cardonick E, Dougherty R, Grana G, Gilmandyar D, Ghaffar S, Usmani A. Breast cancer during pregnancy: maternal and fetal outcomes. Cancer J. 2010;16(1):76-82.

Tobe M, Stephen C, Vasantha K, Shirley A, Bernard R, Phillip X, et al. Breast cancer in pregnancy: case report. Pan Afr Med J. 2010;5(1).

Assi HA, Khoury KE, Dbouk H, Khalil LE, Mouhieddine TH, El Saghir NS. Epidemiology and prognosis of breast cancer in young women. J Thoracic Dis. 2013;5(1): S2.

Shachar SS, Gallagher K, McGuire K, Zagar TM, Faso A, Muss HB, et al. Multidisciplinary management of breast cancer during pregnancy. The Oncol. 2017;22(3):324-34.

Litton JK, Warneke CL, Hahn KM, Palla SL, Kuerer HM, Perkins GH, et al. Case control study of women treated with chemotherapy for breast cancer during pregnancy as compared with nonpregnant patients with breast cancer. The Oncol. 2013;18(4):369-76.

Johnson HM, Mitchell KB. Breastfeeding and breast cancer: managing lactation in survivors and women with a new diagnosis. Ann Surg Oncol. 2019;26:3032-9.

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Published

2023-09-28

Issue

Section

Case Reports