Breast Cancer during Pregnancy and Lactation

ABSTRACT

BACKGROUND: The clinical features of breast cancer associated with pregnancy and lactation remain unknown in many aspects, partly because the incidence is relatively low. The purpose of this study was to evaluate clinicopathologic characteristics and the survival rate of pregnancy-associated breast cancer patients. METHODS: Among 1,265 breast cancer patients treated at the Breast Clinic of Asan Medical Center from July 1989 to December 1998, 13 subjects with breast cancer diagnosed during pregnancy (2 cases) and lactation (11 cases) were evaluated retrospectively. RESULTS: The incidence of pregnancy-associated breast cancer was 1.03% of all breast cancer patients. The mean age and the symptom duration of the subjects was 31.2 years and 8.8 months, repectively. As for surgical procedure, a modified radical mastectomy and breast-conserving surgery were carried out in 10 cases (76.9%) and 2 cases (15.4%), respectively. The median tumor size was 4.0 cm. Lymph node metastases were found in 7 cases (61.5%). According to the TNM classification, all of the patients showed stage II or above tumors. Invasive ductal carcinoma (10 cases, 76.9%) was the most common histopathologic type of tumor. The positive rate of ER and PR in the subjects were 63.6% and 50.0%, respectively. The 3-year overall survival rate and disease-free survival rate were 69.9% and 44.4%, respectively. CONCLUSIONS: This study shows that most of the patients with breast cancer during pregnancy and lactation are in a more advanced stage with a delay in detection and diagnosis, and hence have a unfavorable prognosis.