REVIEW PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Pregnancy associated breast cancer (PABC) is among the most common malignancies occurring in pregnant and postpartum women. Due to the increasing frequency of diagnoses, it is essential to expand our knowledge of diagnostic and therapeutic methods. Clinicians have to make many difficult decisions regarding the health and life of both the patient and the foetus. The aim of the review is to provide an overview of the disease, and delve into the available safe and controversial methods of treatment for PABC.

Review methods:
A review was conducted of scientific publications available in PubMed, Google Scholar, Clinical Key, Via Medica Journals, and guidelines for the diagnostic and therapeutic management of breast cancer. More than 95% of the publications were published within the last eight years.

Brief description of the state of knowledge:
Breast cancer is a widespread and increasing problem affecting women. The question of implementing appropriate imaging studies and subsequent treatment is a set of many difficult questions and decisions made by clinicians. It is mainly recommended to perform surgery, which is allowed at any stage of pregnancy, and chemotherapy after the end of the first trimester of pregnancy. The question of the use of targeted and hormonal therapy ranks among the controversial treatments due to the lack of sufficient studies of the drugs used and their effects on the foetus. Radiation therapy can be considered in necessary situations after calculating the appropriate dose reaching the foetus.

Summary:
The review highlights the epidemiology, risk, prognosis and clinical presentation of PABC. Attention was paid to the available and safe diagnostics used in pregnant women. In addition, it delved into the available therapeutic methods and compared their safety of use at different stages of pregnancy and afterwards.

Piekarz J, Picheta N, Burdan O, Szklener K. Breast cancer associated with pregnancy – a review of therapeutic approaches. J Pre-Clin Clin Res. 2024; 18(2): 156–161. doi: 10.26444/jpccr/189445
 
REFERENCES (55)
1.
Proussaloglou EM, Blanco LZ, Siziopikou KP. Updates in the pathology of Pregnancy Associated Breast Cancer (PABC). Pathology – Research and Practice. 2023;244:154413. https://doi.org/10.1016/j.prp.....
 
2.
Subramani R, Lakshmanaswamy R. Pregnancy and Breast Cancer. Prog Mol Biol Transl Sci. 2017;151:81–111. https://doi.org/ 10.1016/bs.pmbts.2017.07.006.
 
3.
Kakoulidis I, Skagias L, Politi E. Pregnancy associated breast cancer (PABC): Aspects in diagnosis. Breast Disease. 2015;35(3):157–166. https://doi.org/10.3233/BD-150....
 
4.
Pascual O, Uriarte M, Agustín MJ et al. Two cases of breast carcinoma during pregnancy and review of the literature. J Oncol Pharm Pract. 2016;22(4):652–6. https://doi.org/10.1177/107815....
 
5.
Zubor P, Kubatka P, Kapustova I, et al. Current approaches in the clinical management of pregnancy-associated breast cancer-pros and cons. EPMA J. 2018;9(3):257–270. https://doi.org/10.1007/s13167....
 
6.
Johansson ALV, Stensheim H. Epidemiology of Pregnancy-Associated Breast Cancer. Advances in Experimental Medicine and Biology. 2020;1252:75–79. https://doi.org/10.1007/978-3-....
 
7.
Knabben L, Mueller MD. Breast cancer and pregnancy. Horm Mol Biol Clin Investig. 2017;32(1):20170026. https://doi.org/10.1515/hmbci-...
 
8.
Slepicka PF, Cyrill SL, Dos Santos CO. Pregnancy and Breast Cancer: Pathways to Understand Risk and Prevention. Trends Mol Med. 2019;25(10):866–881. https://doi.org/10.1016/j.molm....
 
9.
McDonald JA, Vilfranc CL, Terry MB. The Epidemiology of Pregnancy-Related Breast Cancers: Are We Ready to Deliver? Cancer Epidemiol Biomarkers Prev. 2022;31(3):518–520. https://doi.org/10.1158/1055-9....
 
10.
Jo H, Park S, Kim HR, et al. Long-Term Breast Cancer Outcomes of Pregnancy-Associated Breast Cancer (PABC) in a Prospective Cohort. Cancers (Basel). 2022;14(19):4839. https://doi.org/10.3390/cancer....
 
11.
Ruiz R, Herrero C, Strasser-Weippl K, et al. Epidemiology and pathophysiology of pregnancy-associated breast cancer: A review. The Breast. 2017;35:136–141. https://doi.org/10.3390/cancer....
 
12.
Lee GE, Mayer EL, Partridge A. Prognosis of pregnancy-associated breast cancer. Breast Cancer Res Treat. 2017;163(3):417–421.https://doi.org/10.1007/s10549....
 
13.
Viuff JH, Greiber IK, Karlsen MA, et al. Survival in Women Diagnosed With Breast Cancer During Pregnancy. Clin Breast Cancer. 2022;22(4):517–525. https://doi.org/10.1016/j.clbc....
 
14.
Johansson A LV et al. Tumour characteristics and prognosis in women with pregnancy-associated breast cancer. International Journal of Cancer. 2017;142(7):1343–1354.
 
15.
Schettini F, Prat A. Dissecting the biological heterogeneity of HER2-positive breast cancer. The breast. 2021;59:339–350.https://doi.org/10.1016/j.brea....
 
16.
Łukasiewicz S, Czeczelewski M, Forma A, et al. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers. 2021;13(17):4287. https://doi.org/10.3390/cancer....
 
17.
Wanga B, Yang Y, Jiang Z, et al. Clinicopathological characteristics, diagnosis, and prognosis of pregnancy-associated breast cancer. Throacic Cander. 2019;10(5):1060–1068. https://doi.org/10.1111/1759-7....
 
18.
Polivka J, Altun I, Golubnitschaja O. Pregnancy-associated breast cancer: the risky status quo and new concepts of predictive medicine. EPMA Journal. 2018;9:1–13. https://doi.org/10.1007/s13167....
 
19.
Bakhuis CFJ, Suelmann BBM, van Dooijeweert C, et al. Receptor status of breast cancer diagnosed during pregnancy: A literature review. Crit Rev Oncol Hematol. 2021;168:103494. https://doi.org/10.1016/j.crit....
 
20.
Fazeli S, Sakala M, Rakow-Penner R, et al. Cancer in pregnancy: breast cancer. Abdom Radiol (NY). 2023;48(5):1645–1662. https://doi.org/10.1007/s00261....
 
21.
Dai Y, Liang P, Yu J. Percutaneous Management of Breast Cancer: a Systematic Review. Current oncology reportks. 2022; 24(11): 1443–1459. https://doi.org/10.1007/s11912....
 
22.
Sun J, Lee MC. Clinical Presentation, Diagnosis and Prognosis of Pregnancy-Associated Breast Cancer. Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology. 2020;1252:87–93. https://doi.org/10.1007/978-3-....
 
23.
Boere I, Lok C, Poortmans P, et al. Breast cancer during pregnancy: epidemiology, phenotypes, presentation during pregnancy and therapeutic modalities. Best Pract Res Clin Obstet Gynaecol. 2022;82:46–59. https://doi.org/10.1016/j.bpob....
 
24.
McCormick A, Peterson E. Cancer in Pregnancy. Obstet Gynecol Clin North Am. 2018;45(2):187–200. https://doi.org/10.1016/j.ogc.....
 
25.
Reyes E, Xercavins N, Saura C, et al. Breast cancer during pregnancy: matched study of diagnostic approach, tumour characteristics, and prognostic factors. Tumouri. 2020;106(5):378–387. https://doi.org/10.1177/030089....
 
26.
Langer AK. Breast Imaging in Pregnancy and Lactation Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology. 2020;1252:17–25. https://doi.org/10.1007/978-3-....
 
27.
Carmichael H, Matsen C, Freer P, et al. Breast cancer screening of pregnant and breastfeeding women with BRCA mutations. Breast Cancer Res Treat. 2017;162(2):225–230. https://doi.org/10.1007/s10549....
 
28.
Team of experts. The conventional treatment of pregnant women with 2017;1(1):13–23. https://journals.viamedica.pl/....
 
29.
Safi N, Saunders C, Anazodo A, et al. Clinical Decision Making in the Management of Breast Cancer Diagnosed During Pregnancy: A Review and Case Series Analysis. J Adolesc Young Adult Oncol. 2022;11(3):245– 251. https://doi.org/10.1089/jayao.....
 
30.
Pesapane F, Downey K, Rotili A, et al. Imaging diagnosis of metastatic breast cancer. Insights Imaging. 2020;11(1):79. https://doi.org/10.1186/s13244....
 
31.
Galati F, Magri V, Arias-Cadena PA, et al. Pregnancy-Associated Breast Cancer: A Diagnostic and Therapeutic Challenge. Diagnostic.2023;13(4):604. https://doi.org/10.3390/diagno....
 
32.
Omranipour R. Surgery for Pregnancy-Associated Breast Cancer. Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology. 2020; 1252:95–99. https://doi. org/10.1007/978-3-030-41596-9_12.
 
33.
Alipour S. Local Complications of Breast Surgery during Pregnancy and Lactation. Adv Exp Med Biol. 2020;1252:101–105. https://doi.org/10.1007/978-3-....
 
34.
Eskandari A, Alipour S. Aspects of Anesthesia for Breast Surgery during Pregnancy. Diseases of the Breast during Pregnancy and Lactation. Advances in Experimental Medicine and Biology. 2020;1252:107–114. https://doi.org/10.1007/978-3-....
 
35.
Fisusi FA, Akala EO. Drug Combinations in Breast Cancer Therapy. Pharm Nanotechnol. 2019;7(1):3–23. https://doi.org/10.2174/221173....
 
36.
Shachar SS, Gallagher K, McGuire K, et al. Multidisciplinary Management of Breast Cancer During Pregnancy. Oncologist. 2017;22(3):324–334. https://doi.org/10.1634/theonc....
 
37.
Levey N, Krishna I. Breast Cancer in Pregnancy: Caring for the Very Young Breast Cancer Patient from Diagnosis Through Survivorship. Obstet Gynecol Clin North Am. 2022;49(1):181–193. https://doi.org/10.1016/j.ogc.....
 
38.
Yu HH, Cheung PS, Leung RC, et al. Current management of pregnancyassociated breast cancer. Hong Kong Med J. 2017;23(4):387–394. https://doi.org/10.12809/hkmj1....
 
39.
Loibl S, Azim H A Jr, Bachelot T, et al. ESMO Expert Consensus Statements on the management of breast cancer during pregnancy (PrBC). Annals of oncology: official journal of the European Society for Medical Oncology. 2023;34(10):849–866. https://doi.org/10.1016/j. annonc.2023.08.001.
 
40.
Current management of pregnancy-associated breast cancer 2023;34(10):849–866. https://doi.org/10.1016/j.anno....
 
41.
Ferrigno Guajardo AS, Vaca-Cartagena BF, Mayer EL, et al. Taxanes for the treatment of breast cancer during pregnancy: an international cohort study. J Natl Cancer Inst. 2024;116(2):239–248. https://doi.org/10.1093/ jnci/djad219.
 
42.
Cordeiro CN, Gemignani ML. Breast Cancer in Pregnancy: Avoiding Fetal Harm When Maternal Treatment Is Necessary. Breast J. 2017;23(2):200–205. https://doi.org/10.1111/tbj.12....
 
43.
Jassem J, Krzakowski M, Bobek-Billewicz B, et al. Breast cancer. Oncol Clin Pract 2020;16. https://doi.org/10.5603/OCP.20....
 
44.
Buonomo B, Brunello A, Noli S, et al. Tamoxifen Exposure during Pregnancy: A Systematic Review and Three More Cases. Breast Care (Basel). 2020;15(2):148–156. https://doi.org/10.1159/000501....
 
45.
Schuurman TN, Witteveen PO, van der Wall E, et al. Tamoxifen and pregnancy: an absolute contraindication?. Breast Cancer Res Treat. 2019;175:17–25. https://doi.org/10.1007/s10549....
 
46.
Andrikopoulou A, Apostolidou K, Chatzinikolaou S, et al. Trastuzumab administration during pregnancy: an update. BMC Cancer. 2021;21(1):463. https://doi.org/10.1186/s12885....
 
47.
Tehrani OS. Systemic Treatments in Pregnancy-Associated Breast Cancer. Adv Exp Med Biol. 2020;1252:115–124. https://doi.org/10.1007/978-3-....
 
48.
Jagosky M, Tan AR. Combination of Pertuzumab and Trastuzumab in the Treatment of HER2-Positive Early Breast Cancer: A Review of the Emerging Clinical Data. Breast Cancer: Targets and Therapy.2021;13:393–407. https://doi.org/10.2147/BCTT.S....
 
49.
Schmid P, Salgada R, Park YH, et al. Pembrolizumab plus chemotherapy as neoadjuvant treatment of high-risk, early-stage triple-negative breast cancer: results from the phase 1b open-label, multicohort KEYNOTE-173 study. Annals of Oncology. 2020;31(5):569–581. https://doi.org/10.1016/j.anno....
 
50.
Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for Early Triple- Negative Breast Cancer. The New England journal of medicine. 2020;382(9):810–821. https://doi.org/10.1056/NEJMoa....
 
51.
Flynn J P, Gerriets V. Pembrolizumab, StatPearls, Treasure Island (FL): StatPearls Publishing. 2024. http://www.ncbi.nlm.nih.gov/bo....
 
52.
Amouzegar Hashemi F. Radiotherapy in Pregnancy-Associated Breast Cancer. Adv Exp Med Biol. 2020;1252:125–127. https://doi.org/10.1007/978-3-....
 
53.
Mazzola R, Corradini S, Eidemüeller M, et al. Modern radiotherapy in cancer treatment during pregnancy. Critical Reviews in Oncology/ Hematology. 2019;136:13–19. https://doi.org/10.1016/j.crit....
 
54.
Wong YM, Koh CWY, Lew KS, et al. A review on fetal dose in Radiotherapy: A historical to contemporary perspective. Physica Medica. 2023;105:102513. https://doi.org/10.1016/j.ejmp....
 
55.
Michalet M, Dejean C, Schick U, et al. Radiotherapy and pregnancy. Cancer/Radiothérapie. 2022;26(1–2):417–423. https://doi.org/10.1016/j.canr....
 
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