title: Management of breast cancer during pregnancy.
abstract: BACKGROUND
  Pregnancy-associated breast cancer (PABC) is one of the most common malignancies during pregnancy. Since maternal age at the time of pregnancy is increasing, PABC rate is expected to increase. Diagnostic delays are common.
  
  
  METHODS
  Retrospective observational study analysing twelve pregnant patients with breast cancer who underwent surgical treatment during the period of February 2006 to June 2013 at the Department of Surgery I, University of Insubria Varese.
  
  
  RESULTS
  The median age of pregnant patients was 34 y (range 28-44 y). Three patients were affected by BRCA1 mutation. In six patients diagnosis was made during gestation, in the other six patients breast cancer was discovered during breastfeeding. Ten patients underwent breast-conserving surgery. Sentinel lymph node biopsy was performed in six patients; in one of them it was positive so axillary dissection was simultaneuosly performed. Six patients underwent axillary dissection ab initio. In all cases the histological type was invasive ductal carcinoma; grade 3 in ten patients and grade 2 in two patients. Eleven of twelve patients received adjuvant chemotherapy, one patient both adjuvant and neoadjuvant. In three cases also radiation therapy was performed after delivery. In all cases healthy babies were born. Nine of twelve patients are still alive and disease free, after a median follow-up of 20 months (range 3-52 months). Three patients died from systemic progression of the disease.
  
  
  CONCLUSIONS
  There are no significant series of patients in worldwide literature to develop standard protocols. Pregnant women must be followed by a multidisciplinary team.
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rovera
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Chiappa
authors.affiliation: Senology Unit, Moriggia-Pelascini Hospital, Gravedona, Como, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Coglitore
authors.affiliation: Senology Unit, Moriggia-Pelascini Hospital, Gravedona, Como, Italy.
authors.forename: Giorgio Maria
authors.initials: GM
authors.lastname: Baratelli
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Fachinetti
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy; Senology Research Center, University of Insubria, Varese, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Marelli
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Frattini
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lavazza
authors.affiliation: Unit of Oncology, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Bascialla
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Rausei
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA.
authors.forename: Adriana Dionigi
authors.initials: AD
authors.lastname: Corben
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.affiliation: Unit of General Surgery, Circolo Teaching Hospital, University of Insubria, Varese, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Dionigi
mesh_terms: D000328:Adult; D001942:Breast Feeding; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies
keywords: Breast cancer; Pregnancy-related breast cancer