Breast cancer and pregnancy: How, why, when

Daniilidis A, Hatzis P, Tantanasis T, Dinas K, Nasioutziki M, Carcea F, Giannoulis C, Loufopoulos A

2nd Department of Obstetrics and Gynecology, Aristotelian University of Thessaloniki, Hippokrateio hospital, Thessaloniki, Greece

Correspondence: Hatzis Panagiotis, 2nd Department of Obstetrics and Gynecology, Aristotelian University of Thessaloniki, Hippokrateio hospital, Thessaloniki, Greece. E mail: This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it.

 


 

Abstract

The aim of the present review was to assess the relationship between pregnancy and breast cancer, the influence of pregnancy on mortality and prognosis of the disease, the consequences of breast cancer on pregnancy and to discuss the possible sequelae for the woman’s fertility. Pregnancy does not seem to influence the prognosis of an already established breast malignancy. Unfortunately, delays in diagnosis and treatment are common during pregnancy and the prognosis is thus worsened. Nulliparity, early menarche and late age at first pregnancy are associated with increased risk for breast cancer. Breastfeeding confers a protective effect on the risk of breast cancer, which appears to be related to the duration of breastfeeding and the woman’s age at the time of breastfeeding. In cases of advanced metastatic disease during the first 14 to 15 weeks of pregnancy when chemotherapy is necessary for prompt treatment, termination of pregnancy may be proposed, particularly if the patient is ERpositive. Modified radical mastectomy is the procedure most frequently performed today. In general, chemotherapy should be delayed after the 14 to 15 weeks of gestation and radiation to be reserved post delivery. Breast cancer has equivalent prognosis in pregnant and non pregnant patients when matched by age and stage at diagnosis. It is advised that future pregnancy should be delayed for at least two years after breast cancer treatment and five years in case of metastatic disease.

Key words: pregnancy; breast cancer; chemotherapy; mammography; breastfeeding; metastasis; mastectomy