Carcinoma of breast associated with pregnancy and lactation

Abstract

Out of 840 cases of breast carcinoma seen over a period of ten years, 18 were found to be associated with pregnancy and lactation. According to the mode of onset and presentation of the disease, these patients were divided into four groups. The average age of these patients was 31.9 years old. Thirteen out of 18 patients presented in a very advanced stage of the disease. In a short period, involvement of liver was noticed in 8, brain in 3, and bones and lung in 2 each. The disease was bilaterally simultaneous in two patients. The acceleration of growth was noticed during second and third trimesters of pregnancy as well as during lactation. The termination of pregnancy in three patients did not alter the clinical course of the disease.

PIP: Of 840 cases of breast cancer seen at a clinic in India over a 10-year period, 18 (2.1%) were discovered concomitant with pregnancy and lactation. Records from the study are tabulated. 4 women experienced onset and presentation of the disease during lactation, 4 others experienced onset during pregnancy and presentation during lactation, 6 had an onset of the disease before pregnancy and presentation during pregnancy, 3 had onset of the disease before pregnancy and presentation during lactation, and 1 had a pregnancy subsequent to the occurrence of the disease. The average age of the patients was 31.9 years old. Duration of the presenting symptoms was short and progression of the disease was rapid. Of the 20 affected breasts, all quadrants were involved in 11, indicating the aggressive nature of the disease. Treatment ranged from lumpectomy to radical mastectomy, palliative to radical radiotherapy, ablative or additive hormone therapy, and termination of pregnancy. The prognosis for breast cancer discovered during pregnancy and lactation is poor with the tumor growing and metastasizing rapidly. Some of the relevant literature indicates that increased vascular and lymphatic supply may provide a favorable medium for the growth and metastatic spread. The end of the 2nd and 3rd trimesters of pregnancy and lactation was particularly responsible for accelerated growth of the tumor. The effects of hormones associated with pregnancy and lactation are unclear. Interruption of the pregnancy does not seem to improve survival times.