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The Journal of Obstetrics and Gynecology of India

, Volume 69, Issue 6, pp 514–519 | Cite as

Pregnancy-Associated Breast Cancer: A Realistic Approach

  • Pooja Ramesh
  • Saranya Srikumar
  • Vimaladhithan MahendranEmail author
  • Sobha S. Nair
  • K. Radhamany
Original Article
  • 5 Downloads

Abstract

Background

The number of cancers diagnosed during pregnancy is on the rise, and breast cancer is the most common malignancy. Presently, there are very limited resources and no clear guidelines for managing this peculiar patient population both worldwide and in India. The objective of this study was to find out the incidence of pregnancy-associated breast cancer (PABC) in a tertiary care referral centre and to compare the epidemiological, diagnostic and prognostic factors as well as maternal and foetal outcomes with the most recent literature worldwide.

Methods

We conducted a retrospective descriptive study of women diagnosed with breast cancer in pregnancy and post-partum period at a tertiary care centre in southern India during the period of 10 years (total number of breast cancer patients were 10). We studied the diagnostic and prognostic factors as well as maternal and foetal outcome in patients diagnosed with breast cancer for the first time in pregnancy.

Results

Overall incidence of PABC was found to be 0.6% (n = 10). Mean age at the time of presentation was 30.7 ± 4 years. All cases suspected clinically or on imaging (USG) were confirmed with FNAC, excision biopsy or Trucut biopsy. Out of 10 patients, 70% (n = 7) had an advanced-stage disease on diagnosis. Histopathology suggested 90% (n = 9) had invasive ductal carcinoma and 55.5% (n = 5) had a triple negative receptor status. 20% (n = 2) of our patients had opted for a breast conservation surgery (BCS), and 70% (n = 7) of our patients underwent modified radical mastectomy with neoadjuvant or adjuvant chemotherapy/radiotherapy. One patient had a second trimester MTP in view of stage 4 disease. 77.7% (n = 7) of the nine patients who continued pregnancy underwent LSCS, out of which 57.4% (n = 4) were elective, and MRM was done concurrently with LSCS in 50% (n = 2) of the elective LSCS. The mean birth weight of the 9 neonates was 2.2 ± 0.5 kg. Intrauterine growth retardation was seen in 22.2% (n = 2) neonates. 33.3% (n = 3) of the neonates required NICU support, and one baby expired on post-natal day 16.

Conclusion

With the increasing number of elderly primigravida amongst the urban population, a clear understanding of PABC is becoming more important. A multidisciplinary team approach shall help the clinician not only in reducing the heavy burden of patient responsibility but more importantly, in guaranteeing better quality of treatment, avoiding unnecessary delays in providing interventions and providing adequate treatment.

Keywords

Breast cancer Pregnancy Early diagnosis 

Notes

Compliance with Ethical Standards

Conflict of interest

Pooja Ramesh, Saranya Srikumar, Vimaladhithan Mahendran, Sobha S. Nair and K. Radhamany declare that they have no conflict of interest.

Ethical Standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Institutional and National) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

It is a retrospective study and data were obtained from the medical records only and Institutional ethics committee clearance was obtained prior to the conduct of the study.

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Copyright information

© Federation of Obstetric & Gynecological Societies of India 2019

Authors and Affiliations

  • Pooja Ramesh
    • 1
  • Saranya Srikumar
    • 1
  • Vimaladhithan Mahendran
    • 2
    Email author
  • Sobha S. Nair
    • 1
  • K. Radhamany
    • 1
  1. 1.Department of Obstetrics and GynaecologyAmrita Institute of Medical ScienceKochiIndia
  2. 2.Department of General SurgeryAmrita Institute of Medical ScienceKochiIndia

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