Pregnancy‐Associated Breast Cancer: Significance of Early Detection

Abstract

Pregnancy-associated breast cancer (PABC) is defined as cancer of the breast diagnosed during pregnancy and up to 1 year postpartum. Delays in diagnosis are frequently associated with increased morbidity and mortality. The aim of this article is to determine the significance of early detection of PABC and to alert health care providers to include PABC in the differential diagnosis when evaluating a breast mass in the perinatal period. This integrative literature review evaluated 15 research studies by using the hypothetical deductive model of clinical reasoning to determine factors related to diagnosis of PABC. As women delay childbearing, the incidence of PABC increases with age. In the reviewed studies, breast cancer was diagnosed with greater frequency in the postpartum period than during any trimester in pregnancy. Delay in diagnosis is complicated by axillary lymph node metastasis, high-grade tumors at diagnosis, and poor outcomes. Early detection is a significant predictor of improved outcomes. Diagnostic modalities such as ultrasound, mammography, and biopsy can be safely used for diagnostic purposes in the evaluation of potential cases of PABC during pregnancy.

Health care experiences among women diagnosed with gestational breast cancer

“…The importance of avoiding delay in diagnosis by referring women who present with a breast lump for prompt evaluation is emphasised in the literature (Eedarapalli & Jain, 2006;Ives, Semmens, Saunders & Puckridge, 2002;Ulery et al, 2009;Zanetti-Dallenbach et al, 2006). Weight gain was commonly described as an unexpected and unwelcome side effect and some women suffered from debilitating lymphedema.…”

“…To reduce the risk of delayed GBC diagnosis and improve women's experience of care at this time, Ulery et al (2009) argue that primary health care providers need better education about presentation of breast lumps during pregnancy and lactation. On the other hand, being dismissed when seeking advice about a breast lump can make women resentful about the delay in diagnosis this causes and diminish their trust in all the health professionals they encounter subsequently.…”

“…An Australian populationbased study reported an incidence of GBC of 23.6 per 100,000 pregnancies between the years 1982 and 2000 (Ives, Saunders & Semmens, 2005). This is expected to rise as age of childbearing is increasing in high-income countries (Ulery, Carter, McFarlin & Giurgescu, 2009). …”

miR-21 Expression in Pregnancy-Associated Breast Cancer: A Possible Marker of Poor Prognosis

“…Although it is a relatively infrequent condition with an incidence rate of approximately 1-3 cases per 10,000 pregnancies, frequently delayed diagnosis leads patients to present with large tumors and increased number of positive lymph nodes, both elements associated with poor survival 2, 3 .…”

Empirical Indicators of Psychobiological Needs of Pregnant Women: Integrative Review

“…This is exacerbated when the actions cited are not part of the prenatal care routine, although there are professionals able to provide care [38][39][40]. It is worth mentioning that the frequent and continuous contact of the pregnant woman with the health professional favors the relationship of trust.…”