Background: Breast cancer is the most common malignancy diagnosed during pregnancy. Incidence of breast cancer in pregnant patients is increasing as more women delay childbearing into the fourth decade of life when the risk of malignancy increases. The most common presentation of breast cancer in pregnancy is a palpable mass; however, physiologic gestational breast changes render the clinical examination challenging. As a result, diagnosis of breast cancer during pregnancy may be delayed, leading to more advanced disease, larger tumor size, and higher rate of axillary nodal involvement. As in non-pregnant patients, diagnostic imaging plays a critical role in tumor characterization, locoregional staging, and evaluation for distant metastases in pregnant patients. Accurate imaging evaluation can further inform selection of optimal therapy for this unique patient population. Imaging is therefore essential for expediting appropriate oncologic care of pregnant patients with a new diagnosis of breast cancer. However, there are special considerations that must be assessed to balance risks and benefits to the mother and fetus.
Learning Objectives: 1. Illustrate common and uncommon presentations of breast cancer during pregnancy 2. Summarize maternal-fetal considerations in diagnostic imaging and image-guided biopsy 3. Review tumor subtypes and tumor biology during pregnancy, imaging features, and associated maternal risk factors 4. Outline modalities and associated pregnancy considerations in staging locoregional disease and distant metastasis 5. Highlight how imaging helps guide treatment options including surgery, systemic therapy, and radiation therapy, and unique safety considerations in pregnancy. 6. Review the role of imaging in evaluation of neoadjuvant treatment response during pregnancy 7. Discuss treatment management implications that arise from the overturn of Roe v Wade
Abstract Content/Results: This exhibit will use multimodality imaging via pictorial essay to illustrate imaging in the evaluation and treatment of pregnant patents with newly diagnosed breast cancer. Case examples will demonstrate how diagnostic imaging guides the formation of multidisciplinary treatment plans that optimize maternal and fetal well-being.
Conclusion: Pregnancy poses unique challenges in the detection and management of breast cancer. Diagnostic imaging plays an essential role in the work-up and treatment of breast cancer in pregnant patients. This exhibit will enhance the radiologist’s ability to optimize imaging and care in this patient population.
