Gestational breast cancer: A literature review

With the risk of breast cancer increasing with age and trends in delayed childbearing in modern societies, the diagnosis and management of gestational breast cancer become more imperative and challenging for multi-disciplinary team care. Studies indexed in the PubMed electronic database on the epidemiology, pathology, diagnosis, treatment, and prognosis of gestational breast cancer were reviewed to summarize the principles for the optimal management of these patients. The diagnosis of breast cancer during pregnancy requires limited radiation exposure, with compromised precision. Different pathologic behaviors, including a higher prevalence of negative estrogen and progesterone receptor and positive human epidermal growth factor receptor 2/neu expression, were observed. The surgical treatment should be the same as that in non-pregnant women. Certain chemotherapy agents are relatively safe and feasible during the second and third trimesters. Radiotherapy, endocrine therapy, and trastuzumab should be avoided during pregnancy. With proper treatments, the prognosis is similar to that in non-pregnant breast cancer patients. This article updated the information and consensus regarding gestational breast cancer. However, there has been no prospective randomized controlled trial to address the best diagnosis and management of breast cancer during pregnancy. Further studies are needed to help clinicians to establish the paradigm in breast cancer management during pregnancy.