Breast cancer and pregnancy.

Although breast cancer is a rare event in pregnancy, the consequences of a delay in its detection and of late-stage disease are tragic for the young woman who presents in her childbearing years. Therefore, all pregnant women with breast problems should undergo a careful assessment. Pregnancy is not a contraindication to orthodox investigations for breast cancer, provided that special care is taken to reduce the risk to the developing fetus. Management is also orthodox, and breast cancer in pregnant or lactating women is thought to behave no differently from breast cancer in non-pregnant women, when age, stage and histological type are similar. For women who have developed early breast cancer during pregnancy, termination of the pregnancy does not appear to have a beneficial influence on the disease. There is no convincing evidence that a subsequent pregnancy has any effect on the outcome of a breast cancer that has been managed successfully previously. The prevention of subsequent pregnancy is not an indication for a prophylactic oophorectomy. A decision for further pregnancies must be made by the patient and the family after sound advice is given as to the prognosis and consideration of the social, economic and spiritual factors. There is no evidence that the termination of a subsequent pregnancy will affect beneficially or adversely the prognosis of a patient with breast cancer.