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Background <p>Pregnancy-associated breast cancer, defined as breast cancer diagnosed during pregnancy or within one year postpartum, represents a rare yet increasingly encountered clinical entity. The physiological changes of pregnancy obscure early diagnosis, while therapeutic decisions must balance maternal oncologic benefit against fetal safety. These challenges are particularly pronounced in low- and middle-income countries, where delayed presentation and limited access to coordinated care are common.</p> Methods <p>This narrative review synthesizes current evidence on the diagnosis and management of breast cancer during pregnancy, with emphasis on surgical decision-making and multidisciplinary coordination. Literature from major databases was reviewed, focusing on trimester-specific safety and outcomes of diagnostic modalities and treatment strategies.</p> Results <p>Breast surgery can be safely performed in all trimesters, with the choice between breast-conserving surgery and mastectomy guided by gestational age and the feasibility of deferring radiotherapy. Chemotherapy is contraindicated in the first trimester but may be administered safely during the second and third trimesters using selected regimens. Radiotherapy, endocrine therapy, and targeted agents are deferred until postpartum. Optimal outcomes depend on individualized, trimester-adapted management within a multidisciplinary framework involving surgical, medical, and radiation oncologists, obstetricians, neonatologists, and psycho-oncology support.</p> Conclusion <p>Pregnancy-associated breast cancer demands timely diagnosis and a carefully coordinated, multidisciplinary approach. With evidence-based, trimester-specific strategies, maternal prognosis need not be compromised, and favorable fetal outcomes can be achieved. CDK 4/6 inhibitors are contraindicated in all trimesters of pregnancy and are preferably used in the postpartum period. In PABC, timing is therapy each decision impacts two lives.</p>

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Pregnancy-Associated Breast Cancer: A Narrative Review of Diagnosis and Multidisciplinary Management

  • 期刊论文

  • 发表日期：

    2026年5月19日

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  • Nishitha Prashanth,
  • Ashwin K R.,
  • Rohit Kumar C,
  • N Sapna Lulla,
  • Ram Charith Alva,
  • Somashekhar SP

摘要

Background

Pregnancy-associated breast cancer, defined as breast cancer diagnosed during pregnancy or within one year postpartum, represents a rare yet increasingly encountered clinical entity. The physiological changes of pregnancy obscure early diagnosis, while therapeutic decisions must balance maternal oncologic benefit against fetal safety. These challenges are particularly pronounced in low- and middle-income countries, where delayed presentation and limited access to coordinated care are common.

Methods

This narrative review synthesizes current evidence on the diagnosis and management of breast cancer during pregnancy, with emphasis on surgical decision-making and multidisciplinary coordination. Literature from major databases was reviewed, focusing on trimester-specific safety and outcomes of diagnostic modalities and treatment strategies.

Results

Breast surgery can be safely performed in all trimesters, with the choice between breast-conserving surgery and mastectomy guided by gestational age and the feasibility of deferring radiotherapy. Chemotherapy is contraindicated in the first trimester but may be administered safely during the second and third trimesters using selected regimens. Radiotherapy, endocrine therapy, and targeted agents are deferred until postpartum. Optimal outcomes depend on individualized, trimester-adapted management within a multidisciplinary framework involving surgical, medical, and radiation oncologists, obstetricians, neonatologists, and psycho-oncology support.

Conclusion

Pregnancy-associated breast cancer demands timely diagnosis and a carefully coordinated, multidisciplinary approach. With evidence-based, trimester-specific strategies, maternal prognosis need not be compromised, and favorable fetal outcomes can be achieved. CDK 4/6 inhibitors are contraindicated in all trimesters of pregnancy and are preferably used in the postpartum period. In PABC, timing is therapy each decision impacts two lives.