The management of breast carcinoma in pregnancy and lactation.

Until recent years, the prognosis for breast cancer in pregnancy and lactation was regarded as grave. The current new data suggest that pregnant women with early breast carcinoma may be treated in the same way as nonpregnant women without affecting pregnancy. However, women with breast cancer in their first trimester of pregnancy and in whom axillary lymph nodes are involved, should receive chemotherapy and have their pregnancy terminated. Toward the end of pregnancy, adjuvant therapy, when needed, can be delayed until after delivery. In patients with advanced disease pregnancy should be terminated and subsequent treatment initiated. During lactation, diagnosis of breast carcinoma requires suppression of lactation by means other than estrogens. The carcinoma will be treated by standard methods. After radical mastectomy for breast cancer, subsequent pregnancies are allowed but should be delayed until the period of greatest risk has passed.