Learning objectives
To describe the main epidemiologic and demographic features of pregnancy-associated breast cancer.
To describe and analyze the main imaging techniques and radiologic features used for pregnancy-associated breast cancer diagnosis.
Background
Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy, in the first year postpartum or at any time during breastfeeding.1
Epidemiology
PABC corresponds to less than 3-5% of all cases; however, it represents up to 20% of breast cancers in women up to 30 years.2 The reported incidence of PABC is 15-35 per 100,000 deliveries.3 Incidence is lower during pregnancy, with 2/3 of all cases are detected in the first 6 months postpartum. The average age of the patients is lower than...
Findings and procedure details
Imaging plays a significant role in the diagnosis of PABC. It is a challenging diagnosis since physiological changes seen in pregnancy may limit clinical suspicion imaging techniques utility.
Ultrasound
Ultrasound is the initial image modality with a reported sensitivity of up to 100% and a negative predictive value of up to 100%. 6 Since there is an increase in the nodularity of the gland associated with pregnancy, any mass that persists for more than 2-4 weeks should raise suspicion for malignancy and must be assessed...
Conclusion
Pregnancy-associated breast cancer should be suspected and studied in patients with a palpable mass during pregnancy, the first year of postpartum or lactation and not settle for changes related to pregnancy.
Personal information and conflict of interest
D. O. Soto Trujillo; Ciudad de México/MX - nothing to disclose L. N. Santos; Mexico city, DF/MX - nothing to disclose
References
Litton JK. Gestational breast cancer: Epidemiology and diagnosis.https://www-uptodate.com.pbidi.unam.mx:2443/contents/gestational-breast-cancer-epidemiology-and-diagnosis?search=pregnancy%20associated%20breast%20cancer&source=search_result&selectedTitle=2~19&usage_type=default&display_rank=2#references. Published 2019. Accesed January 12, 2020.
Woo JC, Yu T, Hurd TC. Breast cancer in pregnancy: a literature review. Arch Surg 2003;138:91–98; discussion, 99.
Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 2003; 189:1128.
A. Langer, M. Mohallema . A single-institution study of 117 pregnancy-associated breast cancers (PABC): Presentation, imaging, clinicopathological data and outcome. Diagnostic and Interventional Imaging (2014) 95,...