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Breast
Special Topics
Pregnancy
Pregnancy-Associated Breast Cancer
Pregnancy-Associated Breast Cancer
Laurie Margolies, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Pregnancy-associated breast cancer (PABC): Breast cancer diagnosed during pregnancy or within 1 year post partum; some include cancer at any time during lactation
                • Some discussion of including patients up to 5 years post partum

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Image-Guided Biopsy

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            Selected References

                                            1. Bae SY et al: Clinical Characteristics and Prognosis of Pregnancy-Associated Breast Cancer: Poor Survival of Luminal B Subtype. Oncology. 1-7, 2018
                                            2. Balaya V et al: What about sentinel lymph node biopsy for early breast cancer during pregnancy? J Gynecol Obstet Hum Reprod. 47(5):205-7, 2018
                                            3. Gomez-Hidalgo NR et al: Breast cancer during pregnancy: results of maternal and perinatal outcomes in a single institution and systematic review of the literature. J Obstet Gynaecol. 1-9, 2018
                                            4. Han SN et al: Axillary staging for breast cancer during pregnancy: feasibility and safety of sentinel lymph node biopsy. Breast Cancer Res Treat. 168(2):551-7, 2018
                                            5. Martínez MT et al: Breast cancer in pregnant patients: A review of the literature. Eur J Obstet Gynecol Reprod Biol. ePub, 2018
                                            6. McCormick A et al: Cancer in Pregnancy. Obstet Gynecol Clin North Am. 45(2):187-200, 2018
                                            7. Peccatori FA et al: Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences. Cancer Biol Med. 15(1):6-13, 2018
                                            8. Simoes E et al: Pregnancy-associated breast cancer: maternal breast cancer survival over 10 years and obstetrical outcome at a university centre of women's health. Arch Gynecol Obstet. ePub, 2018
                                            9. Kim YG et al: Clinicopathologic Characteristics of Pregnancy-Associated Breast Cancer: Results of Analysis of a Nationwide Breast Cancer Registry Database. J Breast Cancer. 20(3):264-9, 2017
                                            10. Mangla M et al: Gestational Gigantomastia: A Systematic Review of Case Reports. J Midlife Health. 8(1):40-44, 2017
                                            11. Myers KS et al: Imaging appearance and clinical impact of preoperative breast MRI in pregnancy-associated breast cancer. AJR Am J Roentgenol. 209(3):W177-83, 2017
                                            12. Cardonick E: Pregnancy-associated breast cancer: optimal treatment options. Int J Womens Health. 6:935-43, 2014
                                            13. Vashi R et al: Breast imaging of the pregnant and lactating patient: imaging modalities and pregnancy-associated breast cancer. AJR Am J Roentgenol. 200(2):321-8, 2013
                                            14. Sundgren PC et al: Is administration of gadolinium-based contrast media to pregnant women and small children justified? J Magn Reson Imaging. 34(4):750-7, 2011
                                            15. Amant F et al: Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer. 46(18):3158-68, 2010
                                            16. Ayyappan AP et al: Pregnancy-associated breast cancer: spectrum of imaging appearances. Br J Radiol. 83(990):529-34, 2010
                                            17. Litton JK et al: Breast cancer diagnosis during pregnancy. Womens Health (Lond Engl). 5(3):243-9, 2009
                                            18. Barnes DM et al: Pregnancy-associated breast cancer: a literature review. Surg Clin North Am. 87(2):417-30, x, 2007
                                            19. Bodner-Adler B et al: Breast cancer diagnosed during pregnancy. Anticancer Res. 27(3B):1705-7, 2007
                                            20. Sabate JM et al: Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics. 27 Suppl 1:S101-24, 2007
                                            21. Hahn KM et al: Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer. 107(6):1219-26, 2006
                                            22. Loibl S et al: Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer. 106(2):237-46, 2006
                                            23. Yang WT et al: Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy. Radiology. 239(1):52-60, 2006
                                            24. Annane K et al: Infiltrative breast cancer during pregnancy and conservative surgery. Fetal Diagn Ther. 20(5):442-4, 2005
                                            25. Fanale MA et al: Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy. Clin Breast Cancer. 6(4):354-6, 2005
                                            26. Gentilini O et al: Breast cancer diagnosed during pregnancy and lactation: biological features and treatment options. Eur J Surg Oncol. 31(3):232-6, 2005
                                            27. Kal HB et al: Radiotherapy during pregnancy: fact and fiction. Lancet Oncol. 6(5):328-33, 2005
                                            28. Kerr JR: Neonatal effects of breast cancer chemotherapy administered during pregnancy. Pharmacotherapy. 25(3):438-41, 2005
                                            29. Pavlidis N et al: The pregnant mother with breast cancer: diagnostic and therapeutic management. Cancer Treat Rev. 31(6):439-47, 2005
                                            30. Psyrri A et al: Pregnancy-associated breast cancer. Cancer J. 11(2):83-95, 2005
                                            31. Webb JA et al: The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 15(6):1234-40, 2005
                                            32. Gentilini O et al: Safety of sentinel node biopsy in pregnant patients with breast cancer. Ann Oncol. 15(9):1348-51, 2004
                                            33. Keleher A et al: The safety of lymphatic mapping in pregnant breast cancer patients using Tc-99m sulfur colloid. Breast J. 10(6):492-5, 2004
                                            34. Ahn BY et al: Pregnancy- and lactation-associated breast cancer: mammographic and sonographic findings. J Ultrasound Med. 22(5):491-7; quiz 498-9, 2003
                                            35. Bladstrom A et al: Worse survival in breast cancer among women with recent childbirth: results from a Swedish population-based register study. Clin Breast Cancer. 4(4):280-5, 2003
                                            36. Middleton LP et al: Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features. Cancer. 98(5):1055-60, 2003
                                            37. Rugo HS: Management of breast cancer diagnosed during pregnancy. Curr Treat Options Oncol. 4(2):165-73, 2003
                                            38. Woo JC et al: Breast cancer in pregnancy: a literature review. Arch Surg. 138(1):91-8; discussion 99, 2003
                                            39. Rosner D et al: Breast cancer and related pregnancy: suggested management according to stages of the disease and gestational stages. J Med. 33(1-4):23-62, 2002
                                            40. Shousha S: Breast carcinoma presenting during or shortly after pregnancy and lactation. Arch Pathol Lab Med. 124(7):1053-60, 2000
                                            41. Saber A et al: The milk rejection sign: a natural tumor marker. Am Surg. 62(12):998-9, 1996
                                            42. Liberman L et al: Imaging of pregnancy-associated breast cancer. Radiology. 191(1):245-8, 1994
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Pregnancy-associated breast cancer (PABC): Breast cancer diagnosed during pregnancy or within 1 year post partum; some include cancer at any time during lactation
                                                          • Some discussion of including patients up to 5 years post partum

                                                      IMAGING

                                                      • General Features

                                                        • Mammographic Findings

                                                          • Ultrasonographic Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Image-Guided Biopsy

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      Selected References

                                                                                      1. Bae SY et al: Clinical Characteristics and Prognosis of Pregnancy-Associated Breast Cancer: Poor Survival of Luminal B Subtype. Oncology. 1-7, 2018
                                                                                      2. Balaya V et al: What about sentinel lymph node biopsy for early breast cancer during pregnancy? J Gynecol Obstet Hum Reprod. 47(5):205-7, 2018
                                                                                      3. Gomez-Hidalgo NR et al: Breast cancer during pregnancy: results of maternal and perinatal outcomes in a single institution and systematic review of the literature. J Obstet Gynaecol. 1-9, 2018
                                                                                      4. Han SN et al: Axillary staging for breast cancer during pregnancy: feasibility and safety of sentinel lymph node biopsy. Breast Cancer Res Treat. 168(2):551-7, 2018
                                                                                      5. Martínez MT et al: Breast cancer in pregnant patients: A review of the literature. Eur J Obstet Gynecol Reprod Biol. ePub, 2018
                                                                                      6. McCormick A et al: Cancer in Pregnancy. Obstet Gynecol Clin North Am. 45(2):187-200, 2018
                                                                                      7. Peccatori FA et al: Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences. Cancer Biol Med. 15(1):6-13, 2018
                                                                                      8. Simoes E et al: Pregnancy-associated breast cancer: maternal breast cancer survival over 10 years and obstetrical outcome at a university centre of women's health. Arch Gynecol Obstet. ePub, 2018
                                                                                      9. Kim YG et al: Clinicopathologic Characteristics of Pregnancy-Associated Breast Cancer: Results of Analysis of a Nationwide Breast Cancer Registry Database. J Breast Cancer. 20(3):264-9, 2017
                                                                                      10. Mangla M et al: Gestational Gigantomastia: A Systematic Review of Case Reports. J Midlife Health. 8(1):40-44, 2017
                                                                                      11. Myers KS et al: Imaging appearance and clinical impact of preoperative breast MRI in pregnancy-associated breast cancer. AJR Am J Roentgenol. 209(3):W177-83, 2017
                                                                                      12. Cardonick E: Pregnancy-associated breast cancer: optimal treatment options. Int J Womens Health. 6:935-43, 2014
                                                                                      13. Vashi R et al: Breast imaging of the pregnant and lactating patient: imaging modalities and pregnancy-associated breast cancer. AJR Am J Roentgenol. 200(2):321-8, 2013
                                                                                      14. Sundgren PC et al: Is administration of gadolinium-based contrast media to pregnant women and small children justified? J Magn Reson Imaging. 34(4):750-7, 2011
                                                                                      15. Amant F et al: Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer. 46(18):3158-68, 2010
                                                                                      16. Ayyappan AP et al: Pregnancy-associated breast cancer: spectrum of imaging appearances. Br J Radiol. 83(990):529-34, 2010
                                                                                      17. Litton JK et al: Breast cancer diagnosis during pregnancy. Womens Health (Lond Engl). 5(3):243-9, 2009
                                                                                      18. Barnes DM et al: Pregnancy-associated breast cancer: a literature review. Surg Clin North Am. 87(2):417-30, x, 2007
                                                                                      19. Bodner-Adler B et al: Breast cancer diagnosed during pregnancy. Anticancer Res. 27(3B):1705-7, 2007
                                                                                      20. Sabate JM et al: Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics. 27 Suppl 1:S101-24, 2007
                                                                                      21. Hahn KM et al: Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer. 107(6):1219-26, 2006
                                                                                      22. Loibl S et al: Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer. 106(2):237-46, 2006
                                                                                      23. Yang WT et al: Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy. Radiology. 239(1):52-60, 2006
                                                                                      24. Annane K et al: Infiltrative breast cancer during pregnancy and conservative surgery. Fetal Diagn Ther. 20(5):442-4, 2005
                                                                                      25. Fanale MA et al: Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy. Clin Breast Cancer. 6(4):354-6, 2005
                                                                                      26. Gentilini O et al: Breast cancer diagnosed during pregnancy and lactation: biological features and treatment options. Eur J Surg Oncol. 31(3):232-6, 2005
                                                                                      27. Kal HB et al: Radiotherapy during pregnancy: fact and fiction. Lancet Oncol. 6(5):328-33, 2005
                                                                                      28. Kerr JR: Neonatal effects of breast cancer chemotherapy administered during pregnancy. Pharmacotherapy. 25(3):438-41, 2005
                                                                                      29. Pavlidis N et al: The pregnant mother with breast cancer: diagnostic and therapeutic management. Cancer Treat Rev. 31(6):439-47, 2005
                                                                                      30. Psyrri A et al: Pregnancy-associated breast cancer. Cancer J. 11(2):83-95, 2005
                                                                                      31. Webb JA et al: The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 15(6):1234-40, 2005
                                                                                      32. Gentilini O et al: Safety of sentinel node biopsy in pregnant patients with breast cancer. Ann Oncol. 15(9):1348-51, 2004
                                                                                      33. Keleher A et al: The safety of lymphatic mapping in pregnant breast cancer patients using Tc-99m sulfur colloid. Breast J. 10(6):492-5, 2004
                                                                                      34. Ahn BY et al: Pregnancy- and lactation-associated breast cancer: mammographic and sonographic findings. J Ultrasound Med. 22(5):491-7; quiz 498-9, 2003
                                                                                      35. Bladstrom A et al: Worse survival in breast cancer among women with recent childbirth: results from a Swedish population-based register study. Clin Breast Cancer. 4(4):280-5, 2003
                                                                                      36. Middleton LP et al: Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features. Cancer. 98(5):1055-60, 2003
                                                                                      37. Rugo HS: Management of breast cancer diagnosed during pregnancy. Curr Treat Options Oncol. 4(2):165-73, 2003
                                                                                      38. Woo JC et al: Breast cancer in pregnancy: a literature review. Arch Surg. 138(1):91-8; discussion 99, 2003
                                                                                      39. Rosner D et al: Breast cancer and related pregnancy: suggested management according to stages of the disease and gestational stages. J Med. 33(1-4):23-62, 2002
                                                                                      40. Shousha S: Breast carcinoma presenting during or shortly after pregnancy and lactation. Arch Pathol Lab Med. 124(7):1053-60, 2000
                                                                                      41. Saber A et al: The milk rejection sign: a natural tumor marker. Am Surg. 62(12):998-9, 1996
                                                                                      42. Liberman L et al: Imaging of pregnancy-associated breast cancer. Radiology. 191(1):245-8, 1994