Type:
Educational Exhibit
Keywords:
Breast, Genital / Reproductive system female, Mammography, MR, Ultrasound, Education, Cancer, Neoplasia, Obstetrics, Not applicable
Authors:
D. O. SOTO TRUJILLO1, L. N. Santos2; 1Ciudad de México/MX, 2Mexico city, DF/MX
DOI:
10.26044/ecr2020/C-10885
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 the overall incidence of breast cancer with an average of 32-34 years. The is an intermediate risk associated in patients with family history and BRCA mutations. Most patients do not have a family history of breast cancer. 4
Pathologic Features
As in non-pregnant women, ductal infiltrating adenocarcinoma is the most common histological type, with a lower expression of hormone receptor (estrogen and progesterone). HER 2 is expression is unclear. There is a higher incidence of poorly differentiated and inflammatory breast cancer in PABC.5
Clinical Manifestations
Patients present with a painless palpable mass (90%) or thickening of the skin. At the time of diagnosis tumor usually are large. Lymph node involvement and inflammatory changes are common. Diagnosis is usually delayed due to physiological changes related to pregnancy. 4