A retrospective analysis of breast cancer in pregnancy: a single center experience

Purpose: This retrospective study analyzes the imaging features of pregnancy-associated breast cancer (PABC) using the 5th BI-RADS lexicon for mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI). Methods Medical records from the Breast Imaging Center of the TecSalud healthcare system, covering October 2006 to June 2020, were comprehensively reviewed. The study targeted eligible patients, specifically women with a biopsy-confirmed diagnosis of breast cancer whose initial symptoms manifested during pregnancy or the lactation period, typically within the first year after childbirth. Clinicopathological and imaging characteristics was recorded. Results The study included 39 patients, 41% diagnosed during pregnancy and 59% post-pregnancy, with a median age of 34 years and a positive family history of breast cancer in 36%. Tumor sizes ranged from  5 cm, with 90% classified as infiltrating ductal carcinoma (IDC). High-grade tumors constituted 85%, and triple-negative breast cancers were found in 36%. Axillary metastatic lymphadenopathy was present in 72%. Imaging findings showed high sensitivity for mammography (93.7%) and ultrasound (100%), while MRI revealed masses with heterogeneous enhancement in 88%. At diagnosis, 31% had metastasis, and 20% developed metastases within the first 3 years. Conclusion Prompt evaluation with ultrasound and biopsy of suspicious masses is crucial in pregnant or lactating patients, with both mammography and MRI deemed as safe and complementary imaging modalities for this patient population.