MANAGEMENT OF BREAST CANCER IN PREGNANCY VS FETO MATERNAL OUTCOME – A CHALLENGE

The occurrence of breast cancer during pregnancy presents signicant diagnostic, therapeutic, prognostic, and psychological challenges for both the patient and her family. Additionally, it poses potential risks to the developing fetus, complicating treatment decisions and outcomes. The frequency of pregnancy-associated breast cancer (PABC) is rising, largely due to the increasing trend of delayed childbearing and the rising incidence of breast cancer in young women of reproductive age [1]. Although breast cancer treatments during pregnancy, such as chemotherapy and surgical interventions, have been deemed relatively safe, detailed information regarding obstetric risks remains limited. Breast cancer diagnosed during pregnancy requires a delicate balance, as chemotherapy regimens might adversely affect the fetus, potentially leading to congenital abnormalities or compromising fetal survival. This case report highlights two patients with breast tumors diagnosed during pregnancy, each managed with a multidisciplinary approach to optimize both maternal and fetal outcomes. The rst patient was diagnosed with breast cancer during the rst trimester. A decision was made to proceed with chemotherapy, and the pregnancy was terminated by caesarean section at 36 weeks of gestation, following steroid coverage to ensure fetal lung maturity. The baby was delivered healthy with no apparent congenital anomalies, and the patient resumed her chemotherapy regimen post-delivery. The second patient, a known case of phyllodes tumor, presented with a rapidly progressive left breast swelling at 26 weeks of gestation. The pregnancy was managed conservatively, and the patient underwent full-term vaginal delivery at 37 weeks 4 days. A healthy baby was delivered with no apparent abnormalities, and the mother had an uneventful postpartum recovery. At 4 weeks postpartum, she underwent a left mastectomy, which was completed successfully, and the patient recovered well post-surgery. Both cases underscore the importance of a multidisciplinary approach involving obstetricians, oncologists, surgeons, and neonatologists to optimize outcomes in pregnancy-associated breast tumors. These cases demonstrate that with proper monitoring and timely interventions, good fetomaternal prognoses can be achieved, even in complex clinical scenarios.