Breast Cancer and Pregnancy
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- 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).
- 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 PathophysiologyGenetics
- 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).
- 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.
- Exposure to radiation
- 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.