Audit of Pregnancy Associated Breast Cancer at PINUM Cancer Hospital
Objective: To perform audit of patients presenting with pregnancy associated breast cancer (PABC) in terms of initial stage, grade, histology, disease course and outcome. Study Design: Retrospective, non-interventional study. Settings: Oncology Department of PINUM Cancer Hospital, Faisalabad Pakistan. Duration: Two years from January 2017 to December 2018. Methods: All breast cancer patients presenting during pregnancy and within one year after delivery registered in oncology department of hospital were included in this study. After Complete clinical examination and diagnostic workup patients were treated according to national comprehensive cancer network guidelines (NCCN). Data of all these patients was collected and recorded in predesigned Performa. Results: Data of pregnancy associated breast cancer from January 2017 to December 2018 collected and analyzed. Total number of breast cancer patients in this period were 775. Among these pregnancies associated breast cancer patients were 13 (1.6%). Average age of these patient was 27 (23-28) years, Gravida-2 (1-3). In 90% no risk factor was found and only 1 (8%) received hormonal therapy for infertility. 1 (8%) patient presented after lumpectomy and modified radical mastectomy each, 6 (46%) with fungating /ulcerating growth and 5 (38 %) with recurrence after primary surgical intervention. Stage wise 8 (62%) in Stage III, 2 (15%) stage II & 3 (23%) Stage 1V. Adjuvant chemotherapy given in 4 (31%) and neoadjuvant in 9(69%), prognosis wise 7(54%) are alive and (5)38% expired and (1)8% left the follow up. Among alive patients (4)57%are disease free, (3)43% are in follow-up with bone metastasis, receiving treatment. Conclusion: PBAC is usually not diagnosed at earlier stage due to physiological changes occur during pregnancy. Patients are reluctant to undergo treatment due to fear of abortion/termination of pregnancy and fear of fetal outcome. Treatment of PBAC needs multidisciplinary approach including gynecologist, oncologist and surgeon.