Breast cancer in preg

Question 1

BC prevalance

Answer 1

• Most common cancer in females
• Leading cause of death for women 35-54yo
• 10-20% cases in preg or 1y PN

Question 2

BC in preg

Answer 2

• Preg does not worsen the prog
• Younger women get diagnosed in preg- who have high grade tumours + estrogen neg tumours hence poor prognosis

Question 3

Diagnosis in preg

Answer 3

• USS for breast lump
• USS guided biopsy for HISTOLOGY
• Do not send cytology- inconclusive due to preg changes

Question 4

Staging

Answer 4

• Only if high suspicion of mets
• CXR + Liver USS
• Do not use MRI in preg
• Do not test tumour markers

Question 5

Mx

Answer 5

• Surgical mx- all trimesters
  Reconstruction PN
• Chemo- only in T2/3
• Radio- after delivery or only if organ failure
• Sentinel node biopsy- only if negative axillary USS + needle biopsy
• Only w radioisotope, dont use blue dye

Question 6

Medications

Answer 6

• DONT USE Tamoxifen/Trastuzumab in preg or BF

Question 7

Delivery

Answer 7

• MDT discussion for best plan

Question 8

PN

Answer 8

• Contraception- Non hormonal methods

Question 9

Preg after BC

Answer 9

• Not contraindicated
• No inc risk of survival/recurrence
• Ideally wait 2 years after treatment - high risk of recurrence
• ECHO in preg