Pregnancy-associated breast cancer; A management dilemma in Nigeria

Abstract

Pregnancy-associated breast cancer (PABC) is uncommon. Its management is sometimes controversial and may present ethical problems. This paper presents cases treated in the University of Port Harcourt Teaching Hospital from 1990 to 2002. The case records of patients treated for pregnancy-associated breast cancer were retrieved, studied and are presented with a limited review of the literature on the current management of the disease.


There were 5 nulliparous young women aged between 26 and 32 years with breast cancer involved in 6 pregnancies. One patient had sequential bilateral mastectomy for carcinoma of the breast in pregnancy at two pregnancies, three had the cancer affecting one breast in pregnancy and one had the mastectomy but while on chemotherapy became pregnant and delivered successfully. One patient with advanced disease, refused biopsy and treatment. The diagnosis in 5 instances was intraductal carcinoma. The disease is uncommon but evokes significant emotion in patients and their doctors. The prognosis appears similar to that in non-pregnant women.


The treatment of PABC is similar to that in non-pregnant women except that radiotherapy and chemotherapy may be contraindicated at certain trimesters.


KEY WORDS: Breast cancer, Pregnancy, Management dilemma.


Sahel Medical Journal Vol.7(2) 2004: 69-72