Gestational Breast Cancer Research Articles

What do we know about the psychosocial issues associated with cancer during pregnancy? A scoping review and gap analysis

ObjectivesThere is a global increase in the number of women diagnosed with cancer during their pregnancy and a nascent evidence base to guide their supportive care. The purposes of this...

O84 - Exploring women’s experiences of gestational breast cancer and their interactions with the health care system: a scoping review

Gestational breast cancer (GBC) is defined as a breast cancer diagnosed during pregnancy or in the first twelve months postpartum. A diagnosis of breast cancer during pregnancy is an uncommon occurrence, yet it is one of the most common types of cancer occurring during pregnancy. Cancer management for GBC is complex and multifaceted. Gestational breast cancer management involves midwives, and other health care professionals which can add to the impost of diagnosis. This scoping review aimed to report the evidence of women’s experiences following a diagnosis of GBC and their interactions with the health care system. Guided by the Arksey and O’Malley framework (2005), this review included systematic searches of: Medline; CINAHL; Psych INFO; EMBASE, and SCOPUS databases in addition to six grey literature databases. A total of 25 articles were included. Thematic analysis identified an overarching theme of adjustment which underpinned the narratives of the women and was reinforced with four major themes: psychological impact; motherhood; treatment and communication, and several sub-themes. The relationship between the themes contextualises the enormous complexity of the experiences of women with GBC. Woman centred care places the woman at the centre of her experience. Providing women with a midwife throughout the journey provides continuity of maternity care and improved communication for these women with GBC and their families. At a time of conflicting emotions for women, midwives are well placed to provide holistic care, focusing on the woman’s unique circumstances, and normalising the woman’s experience of motherhood.

Perinatal outcomes of women with gestational breast cancer in Australia and New Zealand: A prospective population-based study.

To determine the epidemiology, clinical management, and outcomes of women with gestational breast cancer (GBC). A population-based prospective cohort study was conducted in Australia and New Zealand between 2013 and 2014 using the Australasian Maternity Outcomes Surveillance System (AMOSS). Women who gave birth with a primary diagnosis of breast cancer during pregnancy were included. Data were collected on demographic and pregnancy factors, GBC diagnosis, obstetric and cancer management, and perinatal outcomes. The main outcome measures were preterm birth, maternal complications, breastfeeding, and death. Forty women with GBC (incidence 7.5/100 000 women giving birth) gave birth to 40 live-born babies. Thirty-three (82.5%) women had breast symptoms at diagnosis. Of 27 women diagnosed before 30 weeks' gestation, 85% had breast surgery and 67% had systemic therapy during pregnancy. In contrast, all 13 women diagnosed from 30 weeks had their cancer management delayed until postdelivery. There were 17 preterm deliveries; 15 were planned. Postpartum complications included the following: hemorrhage (n=4), laparotomy (n=1), and thrombocytopenia (n=1). There was one late maternal death. Eighteen (45.0%) women initiated breastfeeding, including 12 of 23 women who had antenatal breast surgery. There were no perinatal deaths or congenital malformations, but 42.5% of babies were preterm, and 32.5% were admitted for higher-level neonatal care. Gestational breast cancer diagnosed before 30 weeks' gestation was associated with surgical and systemic cancer care during pregnancy and planned preterm birth. In contrast, cancer treatment was deferred to postdelivery for women diagnosed from 30 weeks, reflecting the complexity of managing expectant mothers with GBC in multidisciplinary care settings.

Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement

ObjectiveTo examine the experiences, needs, and perceptions of health professionals(HPs) treating women diagnosed with cancer during pregnancy(gestational cancer, GC). MethodsInterviews were undertaken with Australian HPs who had treated women diagnosed with GC over the previous five years. HPs were recruited via social media, and professional and community networks. Questions focussed upon HPs’ confidence caring for these women, whether current guidelines/training met their needs, psychological impacts of care provision, and service gaps. Interview data were analysed thematically. ResultsTwenty-seven HPs were interviewed; most were oncology HPs(22/27) with experience caring for women with gestational breast cancer and 13 had a breast-specific clinical focus (e.g. breast surgeon). Many were currently treating women with GC(48%) or had in the last 6–12 months(29.6%). Four themes were identified: A clinically complex case, Managing multi-disciplinary care, Centralised resources for health professionals, and Liaison, information and shared experiences for women. HPs found this population personally challenging to treat. They reported initial uncertainty regarding treatment due to infrequent exposure to GC, limited resources/information, and the need to collaborate with services with which they did not usually engage. Solutions offered include centralised resources, clinical liaison/care coordinators, and connecting women with GC with peer support. ConclusionsHPs perceived women with GC as a vulnerable, complex population and experienced challenges providing comprehensive care; particularly when treatment was delivered at geographically separated hospitals. Systemic changes are needed to optimise comprehensive care for these women. Their insights can guide the development of more integrated cancer and obstetric care, and better HP support.

Invasive ductal carcinoma of the breast in a pregnant woman: case report

Gestational breast cancer is the most common cause of cancer in pregnant women. It is a challenging condition for the medical team, since the physiological changes in the breast during this period increase the density of the breast parenchyma, which makes it difficult to detect the nodule on physical and imaging examination, causing delay in diagnosis. We present here a case report of a woman with breast cancer diagnosed during pregnancy. This was a 28-year-old female patient who arrived at the service at 14 weeks’ gestation, diagnosed with invasive ductal carcinoma in the left breast, with T4dN2M0 staging. Neoadjuvant chemotherapy treatment was started with a pause for the cesarean section at 36 weeks’ gestation. After delivery, chemotherapy was restarted, followed by radical mastectomy, radiotherapy and hormone therapy. Two years after the initial diagnosis and still being treated with hormone therapy, the patient presented with musculoskeletal pain, detected on magnetic resonance imaging and bone scintigraphy, as well as several points of metastasis in the spine with pathological fracture of L2-L3, where she was then submitted to decompressive laminectomy. After surgery, radiotherapy of the thoracic and lumbar spine was started, in addition to chemotherapy. Currently, the patient is asymptomatic, being on paclitaxel and transtuzumab, with stable bone scintigraphy and radiography and ultrasound showing no metastases, and the child is healthy after three years of follow-up.

Primary Diffuse Large B-Cell Lymphoma of Breast: A Rare Form of Gestational Breast Cancer

Primary diffuse large B cell lymphoma of the breast is an uncommon form of gestational breast cancer and its presentation during pregnancy is challenging. In our case report, a patient presented with a right breast lump during the first trimester of her pregnancy. Biopsy was taken from right breast mass, which was diffuse large b cell lymphoma (DLBCL) double expressive type. She underwent termination of pregnancy and received 6 cycles of multiagent intense chemotherapy along with central nervous system prophylaxis followed by consolidation involved site radiotherapy (ISRT) to breast and axilla after achieving a complete response. Studies suggest no improvement in the outcome of gestational breast cancer with the termination of pregnancy. However, the presentation of primary DLBCL during pregnancy is extremely rare and the decision regarding pregnancy termination is weighted upon a case by case basis. The paucity of data makes our case report a valuable source for the management of DLBCL breast in pregnancy.

Gestational breast cancer in a patient with Crohn\u2019s disease: two\xa0case reports

BackgroundDiagnosis of breast cancer during gestation is a rare occurrence. In addition, the diagnosis of breast cancer in a patient with Crohn’s disease is not common. We present a rare case of gestational breast cancer in a patient with Crohn’s disease, with a concurrent breast cancer diagnosis in her sister.Case presentationA 31-year-old Syrian woman with Crohn’s disease was diagnosed with breast cancer at 30 weeks gestation; she received neoadjuvant chemotherapy during gestation. Incidentally, her 37-year-old sister was also diagnosed concomitantly with breast cancer. Both sisters underwent and successfully completed surgery and adjuvant therapy. At a 5-year review, both patients showed no signs of recurrence. The Crohn’s disease symptoms have also improved after chemotherapy, and the baby born after gestational chemotherapy is currently 5 years old with normal psychomotor development and without any congenital malformations.ConclusionsThis case report highlights the impact of gestation on breast cancer outcomes, the possibility of giving chemotherapy during gestation, and the effect of chemotherapy on the symptoms of Crohn’s disease.

Neurocognitive outcomes following fetal exposure to chemotherapy for gestational breast cancer: A Canadian multi-center cohort study

BackgroundLimited knowledge exists on outcomes of children exposed prenatally to chemotherapy for breast cancer (BC). The purpose of this study was to compare long-term neurocognitive, behavioral, developmental, growth, and health outcomes of children exposed in-utero to chemotherapy for BC. MethodsThis is a multi-center matched cross-sectional cohort study involving seven cancer centers across the region of Southern Ontario (Canada), and the Hospital for Sick Children (Toronto, Ontario). Using standardized psychological and behavioral tests, we compared cognitive and behavioral outcomes in children exposed to chemotherapy during pregnancy for BC to age-matched pairs exposed to known non-teratogens. ResultsWe recruited 17 parent-child pairs and their matched controls. There were more preterm deliveries in the chemotherapy-exposed group compared to controls (p < 0.05). Full Scale IQ of children in the chemotherapy group was significantly confounded by maternal IQ and prematurity. Exposed children born at term were not different in cognitive outcomes. Children from both groups were similar in their developmental milestones, pediatric anthropometric measurements and health problems. There were no cases of autoimmune cytopenia. ConclusionsThis is the first Canadian prospective comparative study designed to assess pediatric cognition following prenatal exposure to chemotherapy for BC. Chemotherapy was not found to be neurotoxic in this cohort and did not affect pediatric health. The decision to plan a preterm birth for initiating or continuing chemotherapy treatment must be taken into consideration in context of pediatric implications. While these results may assist in such decision making, replication with a larger sample is needed for more conclusive findings.

Gestational breast cancer in New South Wales: A population-based linkage study of incidence, management, and outcomes.

The incidence of gestational breast cancer (GBC) is increasing in high-income countries. Our study aimed to examine the epidemiology, management and outcomes of women with GBC in New South Wales (NSW), Australia. A retrospective cohort study using linked data from three NSW datasets. The study group comprised women giving birth with a first-time diagnosis of GBC while the comparison group comprised women giving birth without any type of cancer. Outcome measures included incidence of GBC, maternal morbidities, obstetric management, neonatal mortality, and preterm birth. Between 1994 and 2013, 122 women with GBC gave birth in NSW (crude incidence 6.8/ 100,000, 95%CI: 5.6-8.0). Women aged ≥35 years had higher odds of GBC (adjusted odds ratio (AOR) 6.09, 95%CI 4.02-9.2) than younger women. Women with GBC were more likely to give birth by labour induction or pre-labour CS compared to women with no cancer (AOR 4.8, 95%CI: 2.96-7.79). Among women who gave birth by labour induction or pre-labour CS, the preterm birth rate was higher for women with GBC than for women with no cancer (52% vs 7%; AOR 17.5, 95%CI: 11.3-27.3). However, among women with GBC, preterm birth rate did not differ significantly by timing of diagnosis or cancer stage. Babies born to women with GBC were more likely to be preterm (AOR 12.93, 95%CI 8.97-18.64), low birthweight (AOR 8.88, 95%CI 5.87-13.43) or admitted to higher care (AOR 3.99, 95%CI 2.76-5.76) than babies born to women with no cancer. Women aged ≥35 years are at increased risk of GBC. There is a high rate of preterm birth among women with GBC, which is not associated with timing of diagnosis or cancer stage. Most births followed induction of labour or pre-labour CS, with no major short term neonatal morbidity.

Breast Cancer During Pregnancy: A Marked Propensity to Triple-Negative Phenotype.

Breast and cervical cancers comprise 50% of all cancers during pregnancy. In particular, gestational breast cancer is considered one of the most aggressive types of cancers, which is a rare but fatal disease. However, the incidence of this type of cancer is increasing over the years and its prevalence is expected to rise further as more women delay childbearing. Breast cancer occurring after pregnancy is generally triple negative with specific characterizations of a poorer prognosis and outcome. On the other hand, it has been pointed out that this cancer is associated with a specific group of genes which can be used as precise targets to manage this deadly disease. Indeed, combination therapies consisting of gene-based agents with other cancer therapeutics is presently under consideration. We herein review recent progress in understanding the development of breast cancer during pregnancy and their unique subtype of triple negative which is the hallmark of this type of breast cancer.

The Experiences and Support Needs of Women With Gestational Breast Cancer in Singapore: A Descriptive Qualitative Study.

Gestational breast cancer is diagnosed during pregnancy or within the first postpartum year. There is a lack of studies on the experiences of ethnically diverse Asian women with gestational breast cancer. The aim of this study was to explore the experiences of Asian women with gestational breast cancer so necessary support can be rendered. This qualitative descriptive study used purposive sampling to recruit 7 women with gestational breast cancer who were following up at the breast center of a tertiary women's hospital in Singapore. Semistructured, individual, face-to-face, audio-recorded interviews were used to explore the in-depth experiences of these women. Data were transcribed verbatim and analyzed using thematic analysis. Three main themes emerged from the thematic analysis: (1) being a sick woman, (2) juggling between being a mother and a patient, and (3) seeking normalcy. Women had to contend with disruptive changes from gestational breast cancer, both emotionally and physically. They were constantly distressed by their altered body images, and family support was vital to help these women cope with their treatments. Alternative support sources included healthcare professionals and the Internet. Gestational breast cancer experiences varied based on the women's encounter perceptions and existing support. Their experiences may be improved through further support to mediate their coping efforts. Future quantitative and qualitative research should explore and evaluate the various aspects of the long-term disease and psychosocial effects of gestational breast cancer. Hospitals should include support strategies in antenatal classes and postnatal workshops to lessen disruptions of the motherhood experiences.

Long-term echocardiographic assessment of descendants of gestational breast cancer patients exposed to anthracycline-based chemotherapy

Abstract Background Breast cancer is the most common cancer in women and the leading cause of cancer death in women. Although gestational breast cancer (GBC) accounts only for a small amount of diagnosis, the incidence is increasing due to delayed childbearing. Treating GBC is a significant challenge, having to maintain a balance between effective treatment for the patient and safety for the descendants. Anthracycline-based chemotherapy (AC) remains to be the systemic treatment of choice in many GBC patients. Although AC in GBC appears to be safe for the descendants, data on the long-term cardiotoxic effects of AC are scarce. Purpose To evaluate long-term cardiotoxicity on descendants of GBC patients exposed to AC during pregnancy or breastfeeding. Methods We retrospectively recruited descendants of GBC patients and classified them according to AC exposure (case group and non-exposed control group). We performed a thorough echocardiographic assessment. Results We identified 7 GBC patients that received AC during pregnancy (n=6) or breastfeeding (n=1). All of them were diagnosed during the second or third trimester. Median cumulative anthracycline dose was 508mg/m2. A total of 8 cases and 5 controls were recruited. Median age at echocardiographic assessment was 10 years in cases and 8 years in controls. None of them had known prior cardiac disease. Echocardiographic parameters were within normal values in both groups (Table 1). Conclusion A long-term echocardiographic assessment showed no abnormalities in a series of descendants of GBC exposed to AC during pregnancy or breastfeeding. This study may contribute to a better understanding of the safety for the descendants of AC during pregnancy or breastfeeding. Funding Acknowledgement Type of funding source: None

Motherhood during or after breast cancer diagnosis: A qualitative study.

Little is known about the process of becoming a mother in women who experienced a breast cancer diagnosis (BC). In this qualitative study, we investigated maternal representations in pregnant women with experience of BC and those with no oncological history. A total of 38 women were recruited, 19 women who experienced a BC diagnosis and 19 who had not. To explore maternal representations, semi-structured interviews were conducted and analysed through thematic analysis. Four main themes were identified: fears and worries, meaning of motherhood, mother-foetus relationship and partner support. Across themes, differences between primiparous and multiparous are reported. Women with gestational breast cancer (GBC) described fear for their own and their child's survival. Women with previous BC recall contrasting emotions. All women with experience of BC perceived breastfeeding as fundamental and inability to do so provoked worry. Relationship with the partner was considered central, while healthy women were projected towards the future triadic relationship. Finding a mental space during pregnancy for the representation of the future child could be hard for women with GBC. Dissimilarities in the experience of motherhood in cancer patients provide insight into psychological aspects that should be taken into account in clinical practice.

Factors associated with gestational breast cancer: case-control study.

The prevalence of gestational breast cancer (GBC) is 1:3,000-10,000 pregnancies. This study aims to identify the risk factors associated with GBC. This case-control study was conducted in the period between January 2004 and December 2014 at a reference maternity hospital for high-risk pregnancies in Rio de Janeiro. Two controls were selected for each case, totaling 21 GBC cases and 42 controls. Data were collected through a review of medical and hospitalization and delivery records. Reproductive, obstetrical, sociodemographic and health-related characteristics were investigated. Results: The mean age of pregnant women in both groups was 35.5 years. Menarche's mean age was also similar (12.3 years) in both groups. Mother's age at first pregnancy was > 30 years in 28.6% of the patients with GBC and in 2.4% of the control group (p = 0.03). Crude and adjusted odds ratio and their respective CI 95% were calculated through conditional logistic regression paired by mother's age. The results show that the risk for GBC increases 27% for each additional year of mother's age at first pregnancy (p < 0.02) and that mothers with lower schooling had higher risk of GBC (OR = 8.49). Conclusion: Our data confirm the association of primiparity over 30 years of age and low level of schooling with GBC.

Abstract P4-10-12: Gestational breast cancer in Singapore women

Abstract Background Gestational breast cancer (GBC), diagnosed during pregnancy or in the first postpartum year, is expected to rise in incidence due to increasing maternal age. GBC poses unique challenges in diagnosis and treatment as clinicians seek to provide optimal treatment for these young patients without compromising neonatal outcomes. We present our retrospective findings from the first study on gestational breast cancer in Singapore. Methods We performed a retrospective study on 88 patients with gestational breast cancer diagnosed from April 2003 to April 2017 at three centres in Singapore. Demographic details, tumour histopathological characteristics, stage, treatment and outcomes data was collected and analysed. Results Eighty-eight patients were diagnosed with GBC at a median age of 35.9 years (26-43 years). Fifty (56.8%) were diagnosed intrapartum and 38 (43.2%) were diagnosed postpartum. Seventeen (19.8%) had a family history of breast cancer but none had proven BRCA mutation. Seventeen patients (19.3%) presented with stage 1, 36 (40.9%) with stage 2, 25 (28.4%) with stage 3, 5 (5.7%) with stage 4 disease. Seventeen patients underwent termination of pregnancy (27.9% of patients diagnosed during pregnancy). Seventeen (19.3%) of patients received neoadjuvant chemotherapy, 8 of whom received it during pregnancy. Forty-eight (54.5%) received adjuvant chemotherapy, 4 of whom received it during pregnancy. Two patients received palliative chemotherapy during pregnancy. Aside from one case of hearing impairment, there was no other documented neonatal complication for patients who received intrapartum chemotherapy. The 5-year and 10-year overall survival (OS) was 80% and 66%. According to the Singapore National Cancer Registry, the 5-year OS for women younger than 44 years of age was 88.9%, therefore suggesting a lower OS in patients with GBC. The 5-year and 10 year disease-free survival (DFS) of our patients was 73% and 60% respectively. Diagnosis of cancer postpartum conferred a higher risk (hazard ratio (95%CI) 1.86 (0.55, 6.28) of mortality compared to those diagnosed intrapartum. Univariate Cox proportional hazard regression model showed that nodal positivity and clinical stage were significantly associated with DFS while only clinical stage was significantly associated with OS. Race was found to affect survival with Malay patients having a lower DFS compared to Chinese patients. Conclusion GBC patients in Singapore have a lower survival rate. Diagnosis of cancer postpartum confers a higher risk of mortality. This might be due to a delay in diagnosis and treatment. Malay patients have a lower survival compared to Chinese patients. Studies into genetic and social factors might shed light on how ethnicity affects survival of these patients. Citation Format: Tan QT, Wong FY, Alcantara VS, Ganguly R, Loh KW-J. Gestational breast cancer in Singapore women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-12.

Breast Cancer in Pregnancy: A Retrospective Cohort Study

Gestational breast cancer (GBC) is the second most commonly occurring malignancy affecting pregnant women. Management is complex due to potential foetal risks in the setting of maternal treatment. We report on the maternal, foetal, short-term neonatal and placental histopathologic findings of a retrospective cohort of pregnant women with either pre-gestational (group 1) or GBC (group 2) from a tertiary-level maternity care centre. Of the 69 women identified over 12 years, there were 47 in group 1 and 22 in group 2. Demographics, stage of breast cancer at diagnosis were similar in the 2 groups. Women with GBC (group 2) were more likely to receive surgery and chemotherapy or surgery alone as compared to those in group 1. No women with GBC received radiation during pregnancy, but 2 received this treatment postpartum. With regard to pregnancy outcomes, induction of labour was more common in women with GBC, as was preterm birth. Most preterm birth in women with GBC was late preterm, iatrogenic in nature to facilitate postpartum treatment. We conclude comparable pregnancy outcomes for women with GBC as compared to those with pregestational breast cancer.

Practical consensus recommendations for gestational breast cancer.

This manuscript provides a practical and easy to use consensus recommendation to community oncologists on how to manage gestational breast cancer.

Gestational breast cancer. Surgical treatment, pregnancy and fetal outcome

Background. Gestational breast cancer (GBC) is also known as pregnancy-associated breast cancer and it comprises all the breast cancers (BCs) which are diagnosed either during pregnancy or in the first year after delivery or during the lactation period. At present it has been confirmed that the breast malignancies are the most common forms of cancer in pregnant women with a constant increase in its incidence because of the continuous postpone in childbearing especially in women older than 40 years. However, when diagnosed during the pregnancy, the treatment modalities of the BC are complex and difficult to establish as it must be considered the impact of the treatment both on the child and the course of pregnancy. Purpose. Using an online search on Pubmed, our aim was to make a review of the treatment possibilities of a pregnant woman presenting a breast malignant tumor. We have concentrated our paper on the surgical treatment and the possibility of an oncoplastic reconstruction types, the facts of radiotherapy during pregnancy and the prognosis of the GBC particularly in women who opt to continue the pregnancy. A resume of the epidemiology of GBG is also presented. Method. The following key words have been on Pubmed introduced: ,,breast cancer’’, ,,pregnancy’’, ,,staging”, ,,chemotherapy” and ,,radiotherapy”. As mentioned above, we have tried to select the BC cases diagnosed and treated during pregnancy for which the decision of the patient was to continue the pregnancy in spite of the diagnosis. We further aimed to present the prognosis of the pregnancy-associated BC, namely the pregnancy and fetal outcome, and to investigate if the decision to terminate the pregnancy is associated with a survival benefit. Conclusion. The surgical treatment of pregnancy-associated BC does not differ from that of non-pregnancy BC. Axillary LN-dissection is permitted while the data on the safety of sentinel-LN are still poor. Elective termination of the pregnancy has no impact on the overall survival of the patient.

Health care experiences among women diagnosed with gestational breast cancer.

Gestational breast cancer (GBC) presents many challenges for women and the clinicians who care for them. The aim of this study was to explore the health care experiences of women diagnosed with GBC to inform and improve clinical care of women in this predicament. Semi-structured interviews were conducted with 17 women who had been diagnosed with GBC in the previous 5years. The overarching themes for perceived quality of care were "communication" and "comprehensive care." "Communication" had two sub themes: "interdisciplinary communication" (the way health professionals from different disciplines communicated with each other about the management of the woman's care) and "patient communication" (how they communicated this to the woman). The "comprehensive care" theme incorporated three sub themes: "the spirit" (psychological care); "the mind" (information provision); and "the body" (management of treatment side effects). Women's own accounts of positive and negative experiences of GBC care provide unique and specific insights which improve understanding of their concerns and needs. The findings can inform advances in quality and efficacy of clinical care; offer guidance for obstetricians, oncologists and allied health professionals about the needs of women diagnosed with GBC and how care can be optimised; and inform the development of resources to assist women and their families.

Image findings of rare case of gestational breast cancer diagnosed in a lactating women with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography

Gestational or pregnancy-associated breast cancer is defined as breast cancer that is diagnosed during pregnancy, in the first postpartum year, or any time during lactation. We report rare imaging findings of a breast cancer seen on fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) study in a 32-year-old lactating woman. The FDG PET/CT study demonstrated uptake in the soft tissue lesion noted in the right breast corresponding to primary lesion and multiple nodes in bilateral axilla, right supraclavicular and mediastinum. In addition, there was FDG tracer uptake in both the breast parenchyma-related to breast feeding. This case illustrates the first case of breast cancer in a lactating woman detected by FDG PET/CT.