Breast Cancer and Pregnancy: Experience of Maternity and Neonatology Center of Tunis-Tunisia

Objectives: This document aims to identify the clinical, therapeutic, and prognostic features of this association and to provide the up-to-date management. Methods and materials: Our study design is retrospective based on 25 cases of pregnancy-associated breast cancer, carried out at the Maternity and Neonatology Center of Tunis over a period of 10 years, between January 2001 and December 2013. Results: The mean age of the patients was 35.84 years. Breast cancer was diagnosed during pregnancy in fourteen patients and after delivery in eleven patients. Pathohistological diagnosis was established by ultrasoundguided biopsy and surgical biopsy in fourteen and seven patients, respectively. The most common histological type was infiltrating ductal carcinoma (96% of cases). Pregnancy was completed in nine patients. The mean gestational age at which delivery occurred was 35.4 weeks. Twenty patients underwent surgical treatment by mastectomy and breast-conserving surgery (lumpectomy) associated with axillary lymph node dissection was performed in three cases. Chemotherapy was allowed during pregnancy, and was given to 23 patients. On the other hand, radiotherapy, antiestrogens (Tamoxifene) and targeted therapies (Herceptin) must be postponed after delivery because of their teratogenic effects. After a 5-year follow-up, two of eighteen patients died and six were lost to follow-up. Conclusion: The poor prognosis of the pregnancy-associated breast cancer is no longer attributed to pregnancy but rather to the young age of the patients and the delay in the diagnosis of cancer. Treatment should be started promptly during pregnancy.