Motherisk update: Breast cancer during pregnancy - Approach to rational management

Question: A 35-year-old women attending my clinic in the 20th week of pregnancy had a lump in her breast. Open biopsy revealed ductal carcinoma. Radical mastectomy with axillary lymph node biopsy showed three out of 10 nodes positive. What are the short- and long-term implications of chemotherapy during pregnancy? ANSWER: Patients with breast cancer during pregnancy should be treated using the same criteria as their nonpregnant counterparts, with the modifications required by pregnancy. The benefits of the diagnostic workup and use of chemotherapy, radiotherapy, and surgery have to be weighed carefully against their risk to the unborn baby.