Pregnancy Associated Breast Cancer: An Institutional Review from a Dedicated Cancer Hospital of Pakistan

Author(s): Sidra Afzal, Nida Javed, Bushra Rehman, Warda Jabeen, Osama Shakeel, Umer Farooq Muhammad Asad Parvaiz, Mohammad Zulqarnain Chaudhary

Introduction

Breast cancer during pregnancy or diagnosed during lactation or 1 year after delivery comes under Pregnancy associated breast cancer (PABC). PABC are diagnosed in age ranging from 32-38 years. It has been noted that PABC is associated with larger tumors and higher incidence of lymph nodes metastases at presentation.

Methodology

It is a retrospective analysis of PABC patients presented at our hospital in year 2020. All patients with PABC are included while Non-PABC and male breast cancer are excluded. Calculations were performed with Statistical Package for the Social Sciences (SPSS Ver20) for Windows. The study is in compliance with the SKMCH&RC guidelines on research involving human subjects.

Results

A total of 899 patients presented with breast cancer at SKMCH in the year 2020. Of these patients, 41 patients (4.56%) had PABC. Mean age at presentation was 33.76 (range 24-41). Except for one patient, all the patients presented with palpable lump in breast. Seven patients (17%) had metastases at the time of presentation. Triple negative disease was observed in 16 patients (39%). We identified only one histological subtype among all patients i.e. invasive ductal carcinoma (IDC), however, five patients (12.2%) had a component of ductal carcinoma in situ along with IDC. More than half of the patient had advanced T stage i.e. 56.1%. Neo-adjuvant chemotherapy was offered in 31 patients (75.6%). 18 patients underwent breast conservation surgery, and 14 patients had mastectomy for the management of disease.

Conclusion

PABC is not very common tumor but it is an aggressive one with unfavorable histological and immunophenotypic characteristics. If any abnormality is noted for more than 2 months, patient should consult a specialist breast surgeon.