7 patients with breast cancers during pregancy and loctation seen at Korea University hospital during a 5 year period(1989-1993) were presented. They were found among 377 cases of breast cancers we experienced during the same period, for an
incidence of
1.9%. Ages ranged from 25 to 37 years with an average of 31.9 years. A disproportionately long interval of average 79 days between the discovery of a lump in the breast by the patient and the actual diagnosis of the breast carcinoma was
impressive.
There patients were diagnosed during the pregnancy and others after delivers. Modified radical mastectomy (Auchincloss) was performed for 6 patients with operable breast cancer. One patients with locally advanced breast cancer was on preoperative
chemotherapy, but she refused the therapy on the way. There were one stage I, two stage Ⅱa, one stage Ⅱb, two stageⅢa and one stage Ⅲb tumors. The literature was reviewed in a attempt to define most appropriate treatment for these patients.
Answers
to traditional questions about breast cancers during pregnancy and lactation are becoming less traditional. Radical mastectomy is almost as curative for pregnant patients with operable cancers as for others and presents little chance of fetal
loss.
Therapeutic abortion does not improve the chance for cure, nor does prophylactic castration. For inoperable or disseminated cancer, effective endocrine ablation or chemotherapy requires therapeutic abortion. Pregancy subsequent to mastectomy
neither
promotes nor diminishes the chance of continued maternal well being. If age and study of disease are taken into account, pregnancy itself seems to have a negligible influence on prognosis.
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