Cancer of the breast and pregnancy: the point of view of the breast cancer specialist

Breast cancer is the most common cancer in pregnant women occurring in about 1 in 3,000 pregnancies; the engorgement of the breasts in this period may hinder detection of masses and delays in diagnosis are common; this delay, the young age can explain that overall survival of pregnant women is generally worse than in nonpregnant women. In early stage cancer surgery is recommended as the primary treatment; radiation must be avoided during this period but chemotherapy, if considered necessary, specially in late stage disease, may be given after the first trimester without risk of fetal malformation; termination of pregnancy has not been shown to have any beneficial effect but may be considered if maternal treatments are limited by continuation of pregnancy. In contrast, pregnancy in patients with a prior history of breast cancer does not appear compromise the survival of women and no deleterious effects have not been demonstrated in the fetus: if a risk of relapse exists for the breast carcinoma, it's recommended that patients wait two or three years after diagnosis before attempting to conceive.