Title: Breast Cancer During Pregnancy: A Comprehensive Literature Review

Breast cancer during pregnancy poses a unique challenge for both patients and healthcare providers.
Understanding the complexities surrounding this condition requires a thorough exploration of the
available literature. A literature review serves as a vital tool in consolidating existing knowledge,
identifying gaps, and guiding future research and clinical practice.

The process of crafting a literature review on breast cancer during pregnancy is inherently
challenging. It demands meticulous searching, critical appraisal, and synthesis of diverse sources
ranging from peer-reviewed articles to clinical guidelines and case studies. Navigating through the
vast array of information, discerning relevant findings, and presenting them in a coherent manner
requires expertise and time.

Key considerations in conducting a literature review on this topic include examining the
epidemiology of breast cancer during pregnancy, elucidating its pathophysiology, assessing
diagnostic and treatment modalities, and evaluating maternal and fetal outcomes. Moreover,
understanding the psychological impact on expectant mothers and their families adds another layer
of complexity to the review process.

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The rest are germ-cell tumors, and occasionally a stromal-cell tumor. Management of pregnancy-
associated breast cancer (PABC) patients. An ongoing international multicenter trial (POSITIVE)
may shed light on the consequences of postponing hormonal therapy. Breast Cancer during
Pregnancy—Current Paradigms, Paths to Explore. This means that the cancer has spread to other
parts of the body. Two studies have found no difference in prognosis of early cancers when matched
for stage and age but a poorer prognosis for patients with stage II or IIIa cancers. 13, 46. Patient
Education Centre, In Community Medicine dept at KEM Hospital established since 2003. Breast
Cancer during Pregnancy—Current Paradigms, Paths to Explore. Despite the small cohort, these
results further support the recommendations above that pregnancy could be continued when treated
with anti-HER2 agents in the first trimester. The relatively good tolerance of the fetus to maternal
chemotherapy in the second and third trimesters may be attributed to limited exposure to the
cytotoxic drugs compared to the pregnant mother. In this context, the pregnancy timeline may be
divided into four sections. This day means to bring understanding to the most serious form of Breast
Cancer disease. J Reprod Med. 1995;40785- 788 Google Scholar 60. Kuerer. Long-term neonatal
outcomes following in-utero exposure to chemotherapy. Moreover, the clinical outcomes in several of
the studies are based on crude assessments that may not reflect subtle changes in neurocognition
function, cardiac function, and future impact on fertility due to the potential gonadotoxic effect to
the evolving gonads during in-utero exposure. While this study included only a small cohort, it
seems like DD chemotherapy is an acceptable option for PABC patients. In general, with diagnosis
during the first half of pregnancy, immediate treatment is advised. International Journal of
Turbomachinery, Propulsion and Power (IJTPP). Breast Cancer during Pregnancy—Current
Paradigms, Paths to Explore. Cancers. 2019; 11(11):1669. There is a growing experience with
pregnancy following radical trachelectomy for fertility preservation in stages IB1 and IB2. Breast
cancer usually builds up with the age or it can be genetics. Some oncologists recommend that women
with stage III cancer wait 5 years and that women with stage IV disease not consider childbearing.
88 The decision on when it is safe to get pregnant again must depend on a realistic assessment of the
worst-case scenario if the mother should relapse during pregnancy or while her children are young. It
occurs in both males and females, however, the incidence of breast cancer in males is rare. J Clin
Oncol. 1999;17855- 861 Google Scholar 44. Guinee. AJR Am J Roentgenol. 1994;1621493 Google
Scholar Crossref 24. Mattison. However, chemotherapy should be administered during the second
and third trimesters, although close monitoring by a multidisciplinary expert team is advised. 3.4.
Hormonal Therapy Adjuvant endocrine therapy is administered in patients with HR-positive breast
cancer. Cardiologic evaluation at 36 months showed normal findings. They get nourishment by
developing new blood vessels in a process called angiogenesis. Incidence:1 in 9 women in the TCR
area develop breast cancer during their lifetime.0.5% of breast cancer cases occur in
men.Survival:Now improving. Collins et al 59 performed 12 breast biopsies during pregnancy, all in
the second or third trimesters, with only 1 complication.
Report Back from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight. ISPRS
International Journal of Geo-Information (IJGI). They report correlation between prematurity and
worse cognitive outcomes; however, this result was independent of cancer treatment. The relatively
good tolerance of the fetus to maternal chemotherapy in the second and third trimesters may be
attributed to limited exposure to the cytotoxic drugs compared to the pregnant mother. No difference
in cognitive and general development. Only five women completed their pregnancy, where the rest
had induced abortion, and all these women were exposed before or during first trimester only.
Journal of Functional Morphology and Kinesiology (JFMK). Chemotherapy is viewed as an
effective treatment Breast Cancer During Pregnancy Pregnancy does not cause breast cancer but you
can start to show your symptoms while pregnant. Clin Obstet Gynecol. 1963;6994- 1001 Google
Scholar Crossref 86. Albrektsen. Breast cancer usually builds up with the age or it can be genetics.
Am J Obstet Gynecol. 1980;137747- 749 Google Scholar 80. Reynoso. Many Cancer Treatment
Centers are providing awareness for breast cancer because in this case, less symptoms are happening.
Patients who wish to continue their pregnancies have a growing array of treatment options. In
addition, they observe prematurity-associated lower cognitive development scores when compared
to the general population. Radiation causes changes to the nipple and milk ducts that also make
lactation challenging. 43, 65. Survival has also improved for women with chronic myelogenous and
lymphocytic leukemias. They subsequently revised that view in a follow-up study and reported a 5-
year survival rate of 32%. 9. Breast Cancer during Pregnancy—Current Paradigms, Paths to Explore.
Cancers. 2019; 11(11):1669. Until additional data are available, pertuzumab is not a recommended
treatment during pregnancy as well. Feature papers are submitted upon individual invitation or
recommendation by the scientific editors and must receive. Work-role of Radiation Therapists in the
Consequences of Adaptive Radiotherap. Of the 3 general anesthesia recipients, 1 also underwent a
modified radical mastectomy at 28 weeks' gestation. No complications were noted during
pregnancies or deliveries in these patients, and all pregnancies resulted in live births without
congenital anomalies. Journal of Otorhinolaryngology, Hearing and Balance Medicine (JOHBM). Jpn
J Cancer Res. 1992;831143- 1149 Google Scholar Crossref 14. Liberman. Clin Nucl Med.
1987;12519- 524 Google Scholar Crossref 28. Mayr. Revealing the mechanism of chemotherapy-
induced placental toxicity may shed light on the potential pathway that may mediate the subsequent
sequel to the embryo. If any treatment of Houston cancer hospital does not give the best result of
treatment then also take the second opinion for cancer sometimes it shows best result. Cancer
therapy is discussed in greater detail in Chapter 57 of Williams Obstetrics, 23rd edition. Evidence
supports that administration of chemotherapy may be safe during the second and third trimesters,
with cessation of treatment three weeks prior to expected delivery.
Breast Cancer during Pregnancy—Current Paradigms, Paths to Explore. However, in the metastatic
setting, when urgently needed, it can be given for a short period of time, while monitoring amniotic
fluid level and fetal growth. Thus, staging examinations should be performed only if results may
alter clinical management. Prematurity is associated with worse neonatal and long-term outcomes,
and thus should be avoided. J Natl Cancer Inst. 1999;911686- 1687 Google Scholar Crossref 41.
Johannsson. Semin Oncol. 2000;27618- 622 Google Scholar 77. Ebert. N Engl J Med. 1994;3315- 9
Google Scholar Crossref 88. Averette. J Clin Oncol. 1999;17855- 861 Google Scholar 44. Guinee. In
the diagnosis procedure, special care should be given to minimizing fetal radiation exposure. In the
diagnosis procedure, special care should be given to minimizing fetal radiation exposure. It seems
reasonable to advise a delay in pregnancy for 2 to 3 years, which is the most critical observation
period. Diagnosis is established by histological examination of involved nodes ( Table 81-2 ). The
main results from these studies are listed in Table 1. Only 40 percent of pregnancies in women with
acute leukemia result in live-born infants. The stage can be used to estimate the person’s prognosis.
Prophylactic chemotherapy or immunotherapy is usually avoided during pregnancy; however,
chemotherapy for active disease is given if indicated. Obstet Gynecol Clin North Am. 1998;25301-
321 Google Scholar Crossref 29. Greskovich. Because aggressive radiation and chemotherapy are
often necessary to affect cure, pregnancy termination may be a reasonable option when the diagnosis
of Hodgkin disease is made in the first half of pregnancy. Please let us know what you think of our
products and services. Breast Cancer during Pregnancy—Current Paradigms, Paths to Explore.
Cancers. 2019; 11(11):1669. Feature papers represent the most advanced research with significant
potential for high impact in the field. A Feature. The main results from these studies are listed in
Table 1. Hormonal therapy should not be used in the first trimester; the risks later in pregnancy and in
the long-term remain unclear. The reader is referred to Chapter 57 of Williams Obstetrics, 23rd
edition, for further discussion of the management of ovarian cancer during pregnancy. European
Journal of Investigation in Health, Psychology and Education (EJIHPE). Visit our dedicated
information section to learn more about MDPI. Such information could be of particular importance
due to the biological similarity of tamoxifen to diethylstilbestrol, which is known to cause long-term
adverse events. The reader is referred to Chapter 57 of Williams Obstetrics, 23rd edition, for in-depth
discussion of therapy for invasive cervical cancer during pregnancy. International Journal of
Translational Medicine (IJTM). Aside from an emergency situation, iatrogenic preterm delivery is not
recommended as prematurity increases the rate of long-term abnormalities and should be avoided.
The new blood vessels supply the tumor with nutrients that promote growth. Facts: -IDC is the most
common cancer making up 70-80% of all breast cancer diagnosis. -IDC is the breast cancer that
affects men. While initial results are promising, only about 20% of treated breast cancer patients
showed response, hence predictive markers are still needed to identify the subset of patients for
which the treatment will benefit the most. As described above, most of the studies found no
significant clinical neonatal adverse outcomes in children exposed in-utero to chemotherapy. Note
that from the first issue of 2016, this journal uses article numbers instead of page numbers. Axillary
dissection is preferred because nodal metastases are commonly found in pregnancy-associated breast
cancers, nodal status affects the choice of adjuvant chemotherapy, and sentinel node biopsy in
pregnant women poses an unknown risk to the fetus from the radioisotope. Journal of Theoretical
and Applied Electronic Commerce Research (JTAER). Paper should be a substantial original Article
that involves several techniques or approaches, provides an outlook for. MRI scan involves radio
waves and magnetic fields to develop images. Surg Gynecol Obstet. 1985;160228- 232 Google
Scholar 7. Gallenberg. If any treatment of Houston cancer hospital does not give the best result of
treatment then also take the second opinion for cancer sometimes it shows best result. Many Cancer
Treatment Centers are providing awareness for breast cancer because in this case, less symptoms are
happening. This article is an open access article distributed under the terms and conditions of the
Creative Commons Attribution (CC BY) license ( ). Gout, Urate, and Crystal Deposition Disease
(GUCDD). She died 23 months after delivery, and her physicians speculated that the changing
expression of ER isoforms in pregnancy may have contributed to tamoxifen resistance. In the first
trimester, a breast conserving approach is more complicated due to the increased time of delay in
radiotherapy, and the patient should be notified of the possible increased risk of local recurrence.
Can Assoc Radiol J. 1998;49172- 180 Google Scholar 20. Nicklas. Report Back from San Antonio
Breast Cancer Symposium (SABCS) 2023: Spotlight. Jpn J Cancer Res. 1992;831143- 1149 Google
Scholar Crossref 14. Liberman. However, in the metastatic setting, when urgently needed, it can be
given for a short period of time, while monitoring amniotic fluid level and fetal growth. Notably, the
mother initially responded to tamoxifen but then progressed rapidly to chemotherapy-resistant
disease in the third trimester. The main results from these studies are listed in Table 1. MBBS, MS -
General Surgery, DNB - Surgical Oncology Breast cancer is among the most common malignancy
during pregnancy. Review ArticlesPrimary Care: Assessing the Risk of Breast Cancer Armstrong K.,
Eisen A., Weber B. Work-role of Radiation Therapists in the Consequences of Adaptive Radiotherap.
Staging is important for several reasons: Staging helps the doctor plan the appropriate treatment.
Gynecol Oncol. 2001;80405- 408 Google Scholar Crossref 74. Shahin. The most common solution to
breast cancer during pregnancy is a lumpectomy or a mastectomy. Cancer in the early stage can be
removed either through mastectomy or removal of the entire breast or through lumpectomy or
removal of the affected tissues. Circulatory shock Cardiogenic Shock Hypovolemic Shock Sepsis,
Septic Shock an.
Because aggressive radiation and chemotherapy are often necessary to affect cure, pregnancy
termination may be a reasonable option when the diagnosis of Hodgkin disease is made in the first
half of pregnancy. According to limited evidence, future pregnancies do not appear to change
survival rates. The radiation dose absorbed by the fetus depends greatly on the distance from
radiation field, which in turn depends on fetal size and location, and hence on gestational age. Breast
Cancer during Pregnancy—Current Paradigms, Paths to Explore. Several reports have studied the
effects of tamoxifen use during pregnancy. The fetus was also exposed to 17 rad (0.17 Gy) of
radiation before pregnancy was determined. Recommended time line for various anti-neoplastic
modalities. My aunt is suffering from breast cancer (stage 3) and her age is 75 years. Chemotherapy
is recommended from week 14 (to allow a ’safe period’ after organogenesis) and should be
discontinued around week 35 until after delivery to avoid myelosuppression at time of delivery.
Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals
from around the world. However, currently, the administration of trastuzumab is not recommended
for PABC patients ( Figure 2 ). Only five women completed their pregnancy, where the rest had
induced abortion, and all these women were exposed before or during first trimester only. Due to the
thickened breast, cancer tumors during pregnancy get unnoticed and hence get diagnosed at an
advanced stage. RESULTS AND CONCLUSIONS: A proactive approach is needed to identify
cases of breast cancer in pregnancy particularly in mutation carriers of BRCA genes and those who
get pregnant for the first time at an advanced age in order to minimize the delay in diagnosis.
Radiographic examinations for staging purposes should be avoided during pregnancy and used only
when the estimated risk of metastatic disease is high, and the results may change clinical decision.
Berry et al 43 performed 14 modified radical mastectomies during pregnancy, including 4 in the first
trimester, without any fetal compromise or preterm labor. Prophylactic chemotherapy or
immunotherapy is usually avoided during pregnancy; however, chemotherapy for active disease is
given if indicated. PABC represents a unique clinical scenario which requires a delicate balance of
risks and benefits for both maternal and fetal well-being. They report a relatively high incidence of
congenital abnormalities of 12.6% after tamoxifen exposure during pregnancy compared to 3.9% in
the general population. Breast cancer during pregnancy or first postpartum year is not caused due to
pregnancy but the hormonal changes during this period which can escalate its growth.
Anesthesiology. 1986;64790- 794 Google Scholar Crossref 58. Mazze. Regular healthy cells get
mutated into cancer cells. Can Assoc Radiol J. 1998;49172- 180 Google Scholar 20. Nicklas. He had
moderate hyaline membrane disease and necrotizing enterocolitis that could be related to
prematurity. An ongoing international multicenter trial (POSITIVE) may shed light on the
consequences of postponing hormonal therapy. Such information could be of particular importance
due to the biological similarity of tamoxifen to diethylstilbestrol, which is known to cause long-term
adverse events. In early pregnancy, 50 to 200 rad (0.5-2 Gy) can place the fetus at risk for permanent
growth restriction. No difference in developmental or behavioral assessments. Feature papers are
submitted upon individual invitation or recommendation by the scientific editors and must receive.
You can download the paper by clicking the button above. Report Back from San Antonio Breast
Cancer Symposium (SABCS) 2023: Spotlight. Investigators speculate that only cancer survivors who
were initially healthy would continue a pregnancy. Ciatto et al 30 determined the staging in 3600
women with clinically operable breast cancer; in their study, 0.3% of chest x-rays films, 0.64% of
bone scans, and 0.24% of liver ultrasonographic scans revealed metastases. Several studies have been
conducted to evaluate the long-term effects, focusing mainly on neurological, psychological,
cognitive and general developmental, as well as cardiac side effects ( Figure 3 ). What is the Status
of Diagnosis and Treatment of Breast Cancer During Pregnan. Magnetic resonance (MR) is more
sensitive than mammography, but has a higher false-positive rate. In this context, the pregnancy
timeline may be divided into four sections. Histopathology Invasive ductal ca Invasive lobular ca
Inflammatory breast ca Middleton LP, et al. Incidence:1 in 9 women in the TCR area develop breast
cancer during their lifetime.0.5% of breast cancer cases occur in men.Survival:Now improving.
Breast cancer is the most common cancer affecting women and accounts for the second highest
incidence of cancer-related death, after lung cancer. Cystoscopy and sigmoidoscopy can be
performed as necessary to rule out mucosal involvement. Surg Gynecol Obstet. 1985;160228- 232
Google Scholar 7. Gallenberg. Normal development. No significant delays in puberty. Although
modified radical mastectomy is the traditional treatment, breast-conserving therapy is increasingly
common. Notably, the mother initially responded to tamoxifen but then progressed rapidly to
chemotherapy-resistant disease in the third trimester. Prematurity was correlated with a worse
cognitive outcome independent of cancer treatment. One literature review found a 13% risk of birth
defects with the use of alkylating agents in the first trimester and a 4% risk later in pregnancy. 76
However, such reviews are subject to reporting bias in favor of malformations. They divide
uncontrollably and quickly create many more or the same harmful cells. The most common finding is
peripheral adenopathy, with neck and supraclavicular nodes commonly involved. Long-term neonatal
outcomes following in-utero exposure to chemotherapy. She helped me through my project and get it
done.. Mrs. Ward. Fine-needle aspiration is often the preferred procedure for definitive diagnosis of a
suspicious breast mass, but has become less popular in the past few years because it has a higher
insufficient tissue sample rate, and findings are difficult to interpret. MBBS, MS - General Surgery,
DNB - Surgical Oncology Breast cancer is among the most common malignancy during pregnancy.
Tumor Metastasis Metastasis: Cells can also break away from the primary, or main tumor and spread
to other parts of the body. In addition, to date, there is a paucity of information on long-term
outcomes of the exposed infants. Note that from the first issue of 2016, this journal uses article
numbers instead of page numbers. However, currently, the administration of trastuzumab is not
recommended for PABC patients ( Figure 2 ). Cardiologic evaluation at 36 months showed normal
findings. Fetal stage of development as well as dose, intensity, and distribution of radiation are
directly related to the toxicity of irradiation during pregnancy.