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Breast Cancer and Pregnancy

Breast Cancer and Pregnancy is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Breast cancer in pregnancy is defined as breast cancer that is diagnosed during pregnancy, during lactation, and up to 12 months postpartum.
  • Breast cancer is the most common malignancy in pregnancy with an estimated prevalence of 1 per 3,000 pregnancies (1).

Epidemiology

Incidence
  • Gestational breast cancer is one of the most common pregnancy-associated malignancies, second only to cervical cancer.
  • Breast cancer is found in about 1 in every 3,000 pregnant women (2).

Etiology and Pathophysiology

Genetics
  • BRCA1 and BRCA2 mutation carriers have greatly increased risk of breast cancer overall and may be more likely to develop breast cancer during pregnancy.
  • Multiparity appears protective in BRCA1 carriers but is associated with increased risk in BRCA2 carriers.
  • Other significant mutations include p53 (Li-Fraumeni syndrome) and PTEN (Cowden syndrome).

Risk Factors

  • Age
    • Increased risk with advanced age
    • First pregnancy after age 30 years increases risk.
  • Early menarche and late menopause
  • Family history
    • Breast cancer in first-degree relatives
    • First-degree relatives with premenopausal breast cancer further increase risk.
  • Nulliparity
  • Exposure to radiation

General Prevention

  • Reduce the risk of breast cancer by maintaining a healthy weight.
  • The benefits with moderate exercise such as brisk walking are seen at all age groups including postmenopausal women.

Commonly Associated Conditions

  • Women with gestational diabetes mellitus (GDM) are at 1.5 times greater risk of breast cancer as compared with women who do not have GDM.
  • Lower risk of breast cancer is observed in women who have pregnancy-related hypertensive disorders such as preeclampsia.

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Citation

Stephens, Mark B., et al., editors. "Breast Cancer and Pregnancy." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816935/all/Breast_Cancer_and_Pregnancy.
Breast Cancer and Pregnancy. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816935/all/Breast_Cancer_and_Pregnancy. Accessed April 26, 2019.
Breast Cancer and Pregnancy. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816935/all/Breast_Cancer_and_Pregnancy
Breast Cancer and Pregnancy [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816935/all/Breast_Cancer_and_Pregnancy.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Breast Cancer and Pregnancy ID - 816935 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816935/all/Breast_Cancer_and_Pregnancy PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -