Examination of Pregnancy-Associated Breast Cancer Management in Conideration of Asociated Ethical Dilemmas

Pregnancy-associated breast cancer (PABC) is breast cancer that is diagnosed during pregnancy, lactation, or within one year of delivery (Ulery, Carter, McFarlin, & Giurgescu, 2009). While the standards approaches to breast cancer treatment include surgery, chemotherapy and radiation, a concurrent pregnancy poses ethical issues due to the potential teratogenicity (i.e., the capability of producing fetal developmental abnormalities) of treatment options that would benefit the mother. Due to the rarity of the condition, case reports, small retrospective studies and literature reviews about PABC treatment are limited in number within the current literature base, thus making evidence-based treatment recommendations difficult. Comtemporary literature suggests that chemotherapy during the first trimester is contraindicated. However, while in-utero exposure to many of the chemotherapeutic agents during the second and third trimesters may increase risk of intrauterine growth retardation and low birth weight, the risk of serious malformation or death of the fetus is not significantly different compared to the risk for the general population of women. PABC treatment requires a strong focus on educating the patient about the risks and benefits of all her options, and providing the appropriate support to make this ethically challenging decision about cancer care and pregnancy.