Pregnancy associated breast cancer-a realistic approach

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 as well as in India.
The objective of this study was to find out the incidence of pregnancy associated breast cancer (PABC) in a tertiary care referral center and to compare the epidemiological, diagnostic and prognostic factors as well as maternal and fetal 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 Amrita Institute of Medical Sciences, Kochi during the period of 10 years. We studied the diagnostic and prognostic factors as well as maternal and fetal 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 31 years. Most patients had an advanced stage disease on diagnosis (70%). Histopathology suggested 90% had Invasive ductal carcinoma and 55.5% had a triple negative receptor status. 20% of our patients had opted for a breast conservation surgery (BCS) and 70% of our patients underwent Modified Radical Mastectomy with neo-adjuvant or adjuvant chemotherapy. One patient had an 1st trimester MTP in view of stage 4 disease. 77.7% underwent LSCS out of which 57.4% were elective and MRM was done concurrently with LSCS in 50% of the elective LSCS.
The mean birth weight was 2.2 kg. Intrauterine growth retardation was seen in 22.2% neonates. 33.3% of the neonates required NICU support and one baby expired on post-natal day 16.

Author(s): Dr Pooja Ramesh, Amrita Institute of Medical Sciences, Kochi, Kerala, India

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