Transcript Pregnancy associated breast cancer (PABC)

Pregnancy associated
breast cancer (PABC)
Lilla Madaras
2nd Department of Pathology
Semmelweis University
Budapest, Hungary
4th Pannonia Congress of Pathology, Osijek, Croatia
May 12-14 2016
Definition
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Breast cancer during pregnancy or within a year
after its cessation
Incidence
• 0,6% of breast cancer cases are pregnancy related
• 1/10 000-1/3000 pregnancies
• Incidence of PABC increasing since women tend to
postpone childbearing to later age
Major clinical issues
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Rare disease, complex situation- not enough
experience with treatment of PABC
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Delayed diagnosis?
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Imaging difficult- young, dense breast altered by
pregnancy related hormonal changes
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Treatment may potentially harm the fetus
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Induced abortion, preterm delivery
Disease biology
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Pathological features of PABC don't differ
significantly from that of early-onset non-PABC
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Mainly TNBC and LuminalB tumors
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Role of tumor microenvironment
Treatment
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Treatment during the second and third trimester
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Current treatment principle is to treat patients with
PABC as close to non-PABC patients as possible
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Pregnancy is considered as of high risk- regular
fetal monitoring
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Long term follow up of individuals with prenatal
chemotherapy
Prognosis
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Conflicting data about prognosis
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Worse outcome (compared to that of young women
with non-PABC) according to some studies