Journal: Obstetrics and gynecology
This publication is a narrative clinical overview of breast cancer in young women, focusing on how pregnancy and future fertility desires affect management.
Key points:
- Distinct entities
- Breast cancer during pregnancy and shortly after delivery are recognized as separate from breast cancer in other young women.
- Postpartum breast cancer is associated with higher rates of metastatic disease and mortality compared with other cases in young women.
- Presentation and diagnosis
- Most young women present after feeling a breast mass.
- Initial evaluation relies on diagnostic breast ultrasound and mammography, even in pregnancy.
- Treatment during pregnancy
- Management is tailored to tumor histology and stage, as in nonpregnant patients.
- Chemotherapy and surgery can be given safely during pregnancy when appropriately selected and timed.
- When standard-of-care treatments are followed, pregnant patients have oncologic outcomes comparable to nonpregnant women.
- Postpartum disease
- Breast cancers diagnosed in the postpartum period have worse outcomes, with increased metastatic risk and mortality, underscoring a need for heightened vigilance and timely treatment.
- Breastfeeding and treatment
- With expert counseling (e.g., breastfeeding medicine), many patients can continue breastfeeding during certain aspects of treatment, when it is safe to do so.
- Fertility and survivorship
- Fertility preservation strategies and future pregnancy are generally feasible and safe for young women with breast cancer when managed with appropriate interventions and timing.