Diagnosis and Management of Metastatic Breast Cancer During Pregnancy by a Multidisciplinary Team: A Case Report

Background: When breast cancer is diagnosed during pregnancy or within thefirst year after delivery, the condition is named as pregnancy-associated breastcancer (PABC). Breast cancer during pregnancy is a devastating situation for thepatient, her family, and the medical team. Providing guidance for diagnosis andtreatment of PABC, we report a case along with review of the literature. Case presentation: Here we present a ۳۱-year-old pregnant woman with lowback pain who was referred to the gynecology ward. She was at ۲۵ weeks and ۶ dayspregnancy. After workup, it was discovered that she had a lytic lesion in her spine.Further workup revealed that she had metastatic breast cancer with the pathology ofinvasive ductal carcinoma. After consultation with a multidisciplinary team (agynecologist, an oncologist, a radiotherapist, a hematologist-oncologist, and aneurosurgeon), we terminated the pregnancy and put her on radiotherapy for thespine metastasis and systemic therapy. Also, we reviewed ۳۶ pregnant patients withprimary or recurrent breast cancer who were managed with outpatientchemotherapy, surgery, or surgery plus radiation therapy. Care was provided bymedical oncologists, breast surgeons, and perinatal obstetricians.Conclusion: Since there are no sufficient data in the literature to guide thedevelopment of standard protocols for management of PABC patients (specially inmetastatic disease), pregnant women must be followed up by a multidisciplinaryteam, and each case should be managed considering the gestational age and thestage of cancer.

Keywords:

Metastatic , pregnancy , diagnosis , management