Case Study Rare Breast Surgery: Chemotherapy given in pregnancy saves the life of 26-year- old Pregnant Breast Cancer patient- Mother-Newborn safe & recovering!!

June 11, 2021

26- year-old Deepika Gopnarayan was recently treated at Jupiter Hospital, Baner, Pune for  Pregnancy Associated Breast Cancer (PABC), a special variant of cancer that can complicate 1 in 3000 pregnancies. Treating breast cancer during pregnancy requires balancing ontologically effective treatments for the mother, with the safe delivery of a healthy baby. A highly skilled team of Breast Surgeons, Oncologists, Obstetricians, and  Pediatriciansat at Jupiter Hospital’s Cancer Institute was involved in forming a multidisciplinary treatment plan. The patient underwent chemotherapy during pregnancy, a vacuum-assisted vaginal delivery at full term, oncoplastic breast surgery after delivery followed by radiation, in what can be described as comprehensive multidisciplinary care.

The diagnosis came as a big surprise to  Deepika and Sugat who were expecting their first child. When Deepika first noted a lump in her breast, it did not immediately raise alarms. She had no family history of cancer and knew she had a benign (non-cancerous lump) fibroadenoma in the same area of the breast diagnosed several years ago. The initial assumption was that it was this fibroadenoma that was growing as expected during pregnancy. However, when the lump grew from 1 cm to over 5 cm over a few weeks, her Obstetrician, Dr. Jyoti Aggrawal knew that this needed specialist care.When Dr Pranjali Gadgil,  Breast Surgeon at Jupiter hospital evaluated Deepika, the lump was almost 5.5 cm. She noted that the fibroadenoma she had before, was nearby but not related to the new growth. Deepika underwent a core needle biopsy in the breast clinic and diagnosed with “Pregnancy-associated Breast Cancer”.

A diligent diagnostic workup with any new breast symptom is imperative irrespective of the patient’s age,  family history, or confounding circumstances such as pregnancy or breastfeeding. According to Dr.  Gadgil, the PABC is a rare disease that occurs in 1 in 3000 pregnancies and often tends to be an aggressive type of breast cancer. It can grow rapidly under influence of hormones and growth factors that abound in pregnancy.  The average age of women who have PABC is  32-38 years of age. Deepika was only 26 years old at diagnosis which is a particularly young age of presentation. There are also some constraints to treating breast cancer when a patient is pregnant. Radiation cannot be given at any time during pregnancy. Chemotherapy cannot be administered during the first trimester during crucial phases of development. We want to avoid general anesthesia for surgery very early in pregnancy and as the mother nears term” she added.