Two lives, one battle: Confronting postpartum breast cancer

Objective: To evaluate the clinical presentation, diagnostic challenges, management strategies, and outcomes of patients with Pregnancy-Associated Breast Cancer (PABC) treated at the Institute of Reproductive Medicine and Women’s Health, Madras Medical Mission, Chennai.

Materials and Methods: This retrospective case series included six patients diagnosed with PABC between January 2022 and December 2024. All patients presented during the lactation period. Demographic details, clinicalpresentation, imaging findings, histopathology, treatment modalities, and outcomes were analyzed. Diagnostic evaluation included ultrasound as the initial modality, followed by mammography or MRI when indicated. Management was individualized based on disease stage and patient status, with multidisciplinary input from surgical, medical, and radiation oncology teams.

Results: All six patients presented with palpable breast lumps, most initially mistaken for benign lactational changes, leading to diagnostic delay. Core-needle biopsy confirmed invasive carcinoma in all cases. Five patients had hormone receptor-positive disease, and one had triple-negative breast cancer. Treatment included modified radical mastectomy, chemotherapy, and hormonal therapy as appropriate. One patient succumbed to sepsis post-treatment, while the remaining five achieved disease control, with one patient continuing therapy. Advanced-stage presentation was a consistent finding, reflecting the diagnostic challenges in lactating women.

Conclusion: Pregnancy-associated breast cancer remains a diagnostic and therapeutic challenge due to overlapping physiological breast changes. Early clinical evaluation, heightened awareness among healthcare providers, and trimester-specific multidisciplinary management are vital to improving outcomes and survival in affected women.