Breast Cancer In Pregnancy: Management Approach

Abstract

About 1-2% of breast cancers occur during pregnancy and lactation, and 7% of fertile women have one or more pregnancies after mastectomy for breast cancers. The high physiological activity of the breast in pregnancy causes the breast to be engorged. There is increased vascularity and lymphatic drainage from the pregnant breast assisting the spread of metastatic process to the regional lymph nodes. The clinical features of cancers of the breast in pregnancy are the same as in the non-pregnant patient. Pregnant patients tend to have a higher incidence of positive lymph nodes, however. Early diagnoses is made possible with awareness of this condition during pregnancy, routine self examination, adequate history, meticulous examination with liberal use of fine needle aspiration biopsy and when necessary open biopsy under local anaesthesia. As in non-pregnant patients all modalities of treatments are intelligently employed in the treatment of breast cancer in pregnancy. Radical mastectomy is well tolerated during pregnancy, and the results of treatment during pregnancy are the same, stage for stage as in the non-pregnant woman. The reported overall survival rate for breast cancer in pregnancy is poor, reflecting the more advanced stage of the disease at diagnosis. An approach to the management of breast cancer in pregnancy is presented by a case illustration and a review of literature. (Nig J Surg Res 2001; 3: 111 – 117) KEY WORDS: Breast Cancer, Pregnancy, Management