Importance Of A Multidisciplinary Approach To Breast Cancer Treatment In Pregnancy: Case Report Of New Diagnosis Of Pregnancy-associated Breast Cancer | 53009
Journal of Cancer Science & Therapy
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Pregnancy-Associated Breast Cancer (PBAC) is a rare diagnosis and includes new diagnoses of cancer both during
pregnancy as well as within the first year post-delivery. Due to its rarity, there is of yet no gold standard treatment nor is
there sufficient scientific data to support a standardized regimen. We report a case involving a 35-year-old G2P1001 who was
diagnosed with clinical stage II (T2 N1) breast cancer in the second trimester of pregnancy after physical examination revealed
a palpable mass. Ultrasound-guided biopsy revealed poorly differentiated infiltrating ductal carcinoma, nuclear grade 3, with
micropapillary features, ER (90%), PR (25%), positive HER2 positive 3+ with Ki67 index 75%. After extensive counseling and
discussion between Obstetrics, Maternal Fetal Medicine, Breast Surgery, Neonatal ICU, and Oncology, a decision was made to
initiate neoadjuvant therapy with Adriamycin and cyclophosphamide. She completed 4 total NAC treatments prior to delivery
then began weekly Taxol plus Herceptin and Perjeta following delivery. This patient strongly desired to carry the pregnancy to
term and began treatment prior to delivery, making this case unique in comparison to other publications in which treatment
was delayed until after delivery, or the pregnancy was terminated prior to beginning treatment. Our case highlights the
importance of a multi-disciplinary approach to counseling these patients as there remains no gold standard of care at this time.
Jeremy Grant completed his MD at Temple University School of Medicine in Philadelphia, Pennsylvania. He is a third-year resident in Obstetrics & Gynecology at Western Pennsylvania Hospital.
Jessica Hoyson completed her MD at Rush University in Chicago, Illinois, and her residency at MetroHealth/Cleveland Clinic in Ohio. She has published several articles in reputable journals on gynecologic malignancies, minimally invasive surgery, and ethics, a textbook chapter on single-site laparoscopy, and presented a surgical film at the national meeting for the Society of Gynecologic Oncology. She is currently on staff at the Western Pennsylvania Hospital in the department of Obstetrics &