Carcinoma breast in pregnancy and lactation

Breast carcinoma is the most common malignancy associated with pregnancy. The incidence is low but increasing due to increasing number of late pregnancies. Symptoms and signs of the disease may be overlooked, resulting in delays in treatment and potentially compromising survival. For this reason, it is imperative that physicians perform careful clinical breast examinations in all pregnant patients-particularly early in gestation, before the breasts become difficult to examine. Upon finding any suspicious breast mass, an open biopsy without delay is indicated. Modified radical mastectomy may be safely performed and is the primary treatment of choice when cancer is diagnosed during pregnancy. Chemotherapy can be given in late pregnancy, and radiotherapy is best avoided. In some cases, especially when disease presents early in gestation, an interruption of the pregnancy may be warranted. Importantly, stage for stage, breast cancer during pregnancy has a similar prognosis to that of breast cancer in young, nonpregnant women; pregnancy itself does not appear to have an adverse effect on the disease process. There is no need for therapeutic abortion. Stage by stage, the prognosis of breast carcinoma in pregnancy is similar to that of non-pregnant controls. With careful counseling, further pregnancy can be planned after 2-3 years in selected cases.