Pregnancy-associated Breast Cancer: A Review of Imaging Modalities

Abstract

Context: The most common cancer and cause of cancer-related death in pregnant and breastfeeding patients is breast cancer. In the world, the incidence of pregnancy-associated breast cancer (P.A.B.C) is increasing, which is due to the fact that women delay their pregnancy up to the middle ages. According to the definition of P.A.B.C, a pregnancy-associated breast cancer is a case of breast cancer that occurs during pregnancy or up to 1 year after delivery. The aim of this paper is to review the clinical findings and novel imaging methods and findings, which help to diagnose pregnancy-associated breast cancer early. Evidence Acquisition: We reviewed the papers with subjects of PABC and imaging modalities in PABC by searching the medical and health databases such as PubMed, Google Scholar, as well as clinical trials. Results: The most frequent manifestation is a painless mass sensation. The most prevalent pathology of PABC is high-grade ductal carcinoma. The first diagnostic tool and most sensitive modality of imaging in this disease is ultrasound. Mammography during pregnancy and lactation is a safe method, which performs in symptomatic patients or in patients with positive ultrasound findings. MRI is not recommended during pregnancy, but it is completely harmless in breastfeeding patients and it is usually used as the complementary modality. Conclusions: Timely diagnosis of PABC requires complete knowledge of clinical symptoms and accurate interpreting of the images in different diagnostic modalities including mammography, ultrasound, and MRI. It should be noted that delay in diagnosis of PABC is the most common cause of low survival rate and bad prognosis.

Breast Cancer during Pregnancy—Current Paradigms, Paths to Explore

“…Due to physiological changes during pregnancy which were discussed above, initial presentation in PABC patients is usually a palpable and painless lump. The initial diagnosis is made by using a breast ultrasound, as this method is considered safe and has high sensitivity and specificity [16]. In any case of suspicious mass, an ultrasound-guided core biopsy under local anaesthesia should be made immediately as histopathologic diagnosis based on core biopsy of the suspicious lesion is the gold standard for PABC.…”

The Management of Breast Cancer during Pregnancy in the Maternity Ward of Rabat in Morocco - A Case Report

“…An initial diagnosis can be made by using breast ultrasound, as this method is considered safe and has high sensitivity and specificity [6]. If there are any suspicious features or ultrasound is not enough, then it is prudent to proceed with bilateral mammography (with abdominal shielding) to exclude bilateral and multicentric disease.…”