Update on the Management of Breast Cancer during Pregnancy

SIMPLE SUMMARY: The diagnosis of cancer during pregnancy represents a challenging situation, leading to a complex management aimed at maximizing the curative approach to the patient while minimizing potential adverse events towards the baby. The different treatment strategies can be combined according to the gestational age. However, to date, data regarding breast cancer care occurring during pregnancy are mostly derived from retrospective reports, thus the inclusion of patients in dedicated registries is advisable. This review aims at reporting the updates on this topic, giving insights into practical aspects of the management of this uncommon and demanding situation. ABSTRACT: The diagnosis of breast cancer during pregnancy represents a challenging situation for the patient, her caregivers and physicians. Pregnancy adds complexity to oncological treatment planning, as many therapies can be potentially dangerous to the fetus. Therefore, a multidisciplinary approach is needed to offer a proper care for obtaining the best possible outcomes for the mother and the future child. Breast surgery is feasible throughout the pregnancy while radiotherapy should be postponed after delivery. Administration of chemotherapy is considered safe and can be given during the second and third trimesters, while it is contraindicated in the first trimester due to the high risk of fetal malformations. Endocrine therapy and targeted agents are not recommended during the whole pregnancy period; however, limited data are available on the use of the majority of new anticancer drugs in this context. The aim of the current review is to provide an update on the current state of art about the management of women diagnosed with breast cancer during pregnancy.