Clinical case: pregnancy-associated breast cancer
Keywords:pregnancy-associated breast cancer, full-field digital mammography, breast MRI, breast ultrasound, digital breast tomosynthesis
This article presents a clinical case of pregnancy-associated breast cancer. We have analyzed the features of the diagnostic algorithm, considered the radiological manifestations and presented the main literature sources about this pathology.
Pregnancy-associated breast cancer is breast cancer that occurs during pregnancy or within the first year after a baby birth. It is most often diagnosed only after first clinical symptoms, the most characteristic of which is a feeling of compaction in the breast, less often bloody discharge from the nipple, pain, breast deformation and baby's refusal to breastfeed.
Radiological signs of pregnancy-associated breast cancer are not pathognomonic and may mimic benign changes associated with pregnancy and lactation at early stage: lactation adenoma, mastitis, abscess, galactocele, fibroadenoma. Uncertainty of physicians about the harm of radiological methods of examination for pregnant women and the fetus and, consequently, incorrect diagnostic algorithms can delay the early detection of pathology, establish an accurate diagnosis and worsen the prognosis for the patient.
Compliance with a sequential diagnostic algorithm using sonographic diagnostics, X-ray mammography with digital breast tomosynthesis, magnetic resonance imaging in accordance with the diagnostic categories of the BI-RADS scale allows you to verify breast tumors. Diagnosis should be consistent with American College Radiology guidelines.
In case of detection of suspicious breast pathology in a pregnant woman or woman in labor, a doctor of any specialty should refer the patient to specialized specialists in the diagnosis and treatment of breast diseases. Adherence to the correct algorithms for the appointment, conduct and interpretation of radiological studies, taking into account changes in the breast structure, will allow timely diagnosis, proper treatment and save the lives and health of childbearing aged women.
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Copyright (c) 2021 А.Ю. Ковтун, А.В. Гурандо, В.В. Тельний, Л.О. Лісюткін, О.Г. Аксьонова, Д.В. Помінчук
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