Background A 29-year-old female presented with a palpable right breast mass at a 12-week prenatal visit. She had no family history of breast or ovarian cancer. Ultrasound revealed a 3 cm lobulated mass, which was confirmed to be malignant by a core biopsy. Postmastectomy pathology at 15 weeks' gestation demonstrated this mass to be a stage T2N0M0 high-grade invasive ductal carcinoma with 0/20 axillary nodes involved. A staging CT scan postpartum showed an enlarged right internal mammary lymph node, confirmed by MRI as suspicious for malignancy.
Investigations Physical examination, breast ultrasound, core biopsy, mastectomy, CT scan, MRI.
Diagnosis Pregnancy-associated breast carcinoma.
Management Mastectomy, chemotherapy and radiotherapy.
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- ULTRASMALL SUPERPARAMAGNETIC IRON OXIDE (USPIO)
MRI contrast used to detect functional, rather than architectural, changes to identify nodal metastases from solid tumors
Doxorubicin, cyclophosphamide and paclitaxel
- IPSILATERAL SUPRACLAVICULAR FOSSA
Regional lymph nodes on the same side of the body as the tumor that are a potential site of nodal drainage from the internal mammary or axillary lymph nodes
- AJCC STAGING SYSTEM
A clinical and pathological staging system established by the American Joint Committee on Cancer to reflect prognostic factors for survival in most solid tumors, including breast cancer
- SENTINEL LYMPH-NODE MAPPING
Minimally invasive surgery to assess lymph nodes most likely to be affected by the spread of a primary solid tumor
European Organization for Research and Treatment of Cancer
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Katz, M., Schapira, L., Harisinghani, M. et al. Palpable right breast mass in a pregnant woman. Nat Rev Clin Oncol 2, 218–221 (2005). https://doi.org/10.1038/ncponc0135