Management of pregnancy associated breast cancer

Abstract

Background: The peak age incidence for breast cancer in developing countries is 35-45 years, which is part of the reproductive years of our women. As women defer childbearing on account of education and careers, the incidence of pregnancy associated breast cancer is expected to increase. Aim: This study presents 4 cases of pregnancy associated breast cancer (PABC) to illustrate the challenges and dilemma in the management of these patients. Methods: The clinical features, stage of presentation of the disease, treatment and outcome of treatment of 4 patients with PABC are reviewed. Results: There were live births of normal babies by all 4 patients, but 100% mortality as all the 4 patients with PABC died within 18 months of delivery from metastatic breast cancer. Conclusion: Seventy to 80% of non-pregnant patients present with advanced breast cancer. PABC as illustrated by these 4 cases presented at worse stages of the advanced cancer. The late stage at diagnosis of PABC and the desire by the patients to have normal live birth at term have worsened prognosis for the PABC patients in our environment. Recommendation: Multidisciplinary team approach by midwives, obstetricians, surgeons and counselors using BSE, CBE and screening at ante-natal clinics for early detection and diagnosis. Counselors to assist patients take decision in the best interest of patient and unborn baby to reduce morbidity and mortality. Keywords: Pregnancy, Breast, CancerPort Harcourt Medical Journal Vol. 3 (1) 2008: pp. 37-41