Breast cancer in pregnancy

Breast cancer in pregnancy

Pregnancy is associated with aggressive tumour biology such as TNBC. Ultrasonography of the breast, mammogram and chest radiograph with abdominal shielding of the fetus may be considered. In cases where bone or brain metastasis is suspected or other investigations are inconclusive, MRI - without gadolinium contrast should be used. CT and PET-CT - should be avoided (high radiation dose). Genetic counselling should be o ff ered. Surgery can be performed in any trimester. Joseph F Fraumeni Jr , b. 1933, National Institutes of Health, Indications for genetic risk evaluation /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF Mastectomy is preferred during the first and second trimester as the delay in administering radiotherapy until delivery may be associated with a higher risk of recurrence in the breast. SLNB with low-dose technetium-tagged sulphur colloid is considered safe for the fetus. Chemotherapy should not be administered during the first trimester (period of organo genesis) but can be safely administered during the second and third trimesters (until 34 weeks to allow haematological recovery at the time of delivery). Anthracyclines and taxanes remain the preferred agents. 5-Fluorouracil should be avoided. Anti-HER2/neu and endocrine therapy should be given after delivery , as indicated.

An individual at any age with a known pathogenic/likely pathogenic variant in a cancer susceptibility gene within the family Breast cancer diagnosed age ≤ 50 years TNBC diagnosed age ≤ 60 years Two breast cancer primaries Breast cancer at any age with one or more relative with breast cancer diagnosed ≤ 50 years, invasive ovarian cancer, male breast cancer, pancreatic cancer, high-grade or metastatic prostate cancer Breast cancer at any age with two or more affected relatives Male breast cancer An individual with a personal or family history of three or more of the following: Breast cancer, sarcoma, adrenocortical carcinoma, brain tumour, leukaemia Colon cancer, endometrial cancer, thyroid cancer, kidney cancer, dermatological manifestations, macrocephaly or hamartomatous polyps of the gastrointestinal tract Lobular breast cancer, diffuse gastric cancer Breast cancer, gastrointestinal cancer or hamartomatous polyps, ovarian sex chord tumours, pancreatic cancer, testicular Sertoli cell tumours or childhood skin pigmentation