Pregnancy-Associated Breast Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Pregnancy-associated breast cancer:
    • Is fortunately a rare entity:
      • In which breast cancer is diagnosed during the pregnancy or the first year after delivery
  • The surgical care of these patients is the same as non-pregnant patients:
    • Sentinel node biopsy:
      • Can safely be performed during pregnancy:
        • Therefore, axillary dissection is not warranted
      • However, only radioactive dye should be used
    • Patients can safely undergo breast-conserving surgery:
      • With radiation occurring after delivery
  • Anthracycline-based chemotherapy:
    • Is safe during the 2nd and 3rd trimester:
      • A study by Litton, et al:
        • Showed children exposed to chemotherapy in utero had normal development and the rate of congenital abnormalities were similar to national averages
  • Biologic and hormonal therapies:
    • Are contraindicated during pregnancy
  • While termination is not mandatory to allow treatment of the malignancy:
    • Close monitoring by an obstetrician experienced in high-risk pregnancies:
      • Is recommended to monitor the fetus and to determine the best time to complete chemotherapy to ensure that the patient does not deliver during a nadir, thus minimizing risk at the time of delivery
  • References:
    • Guidroz JA, Scott‐Conner CE, Weigel RJ. Management of pregnant women with breast cancer. J Surg Oncol. 2011;103(4):337-340.
    • Shah NM, Scott DM, Kandagatla P, et al. Young women with breast cancer: fertility preservation options and management of pregnancy-associated breast cancer. Ann Surg Oncol. 2019;26(5):1214-1224.
    • Murthy RK, Theriault RL, Barnett CM, et al. Outcomes of children exposed in utero to chemotherapy for breast cancer. Breast Cancer Res. 2014;16(6):500.
    • Shachar SS, Gallagher K, McGuire K, et al. multidisciplinary management of breast cancer during pregnancy. Oncologist. 2017;22(3):324–334. Erratum in: Oncologist. 2018;23(6):746.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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