Pregnancy-Associated Breast Cancer

Breast cancer diagnosed during pregnancy or in the first postpartum year is referred to as pregnancy-associated breast cancer (PABC). With more women postponing childbearing until later in life, the incidence of PABC is expected to increase. Often there is a delay in diagnosis as small tumors are difficult to detect on a physical examination, and new findings may be obscured against the background of normal physiologic changes associated with pregnancy. Therefore, PABC tends to be diagnosed at a more advanced stage. Once an abnormality is suspected, diagnostic testing should be pursued. Breast ultrasonography is the imaging study of choice, although mammography can be safely performed with proper shielding. Magnetic resonance imaging with contrast is contraindicated due to possible teratogenic effects of gadolinium. Core-needle biopsy of any suspicious masses should be performed. After the establishment of the diagnosis, multidisciplinary treatment planning should be undertaken to optimize the outcome for both the mother and the baby. As certain systemic therapy agents and radiotherapy cannot be safely given during pregnancy, the sequence and timing of the different components of m