# The Role of Breast Examination in Prenatal Care: A Case Report

## TL;DR

A case report shows the challenges of diagnosing and treating breast cancer during pregnancy, highlighting the need for breast evaluation despite current guidelines.

## Contribution

This case report emphasizes the importance of breast examination during pregnancy despite current guidelines not recommending it.

## Key findings

- A 35-year-old pregnant woman was diagnosed with advanced triple-negative breast cancer at 30 weeks gestation.
- Neoadjuvant chemotherapy and cesarean delivery at 37+5 weeks resulted in a healthy infant, but the cancer progressed despite treatment.
- The patient's case highlights the need for breast evaluation during pregnancy due to diagnostic and psychological challenges.

## Abstract

Pregnancy-associated breast cancer (PABC) is a relatively rare but clinically significant condition. Diagnosis is often delayed, as physiological breast changes during pregnancy can obscure malignant findings, resulting in more advanced disease at presentation. PABC poses unique diagnostic and therapeutic challenges due to its rarity and the complexity of managing maternal and fetal health. This case highlights these challenges in a 35-year-old woman at 30 weeks of gestation who presented with a large, painful left breast mass. Open biopsy confirmed grade 3, triple-negative, infiltrating ductal carcinoma. Axillary lymphadenopathy was present, and staging revealed liver, bone, and lung metastases. Neoadjuvant chemotherapy was administered, followed two weeks after the last dose by cesarean delivery at 37+5 weeks, resulting in the birth of a healthy infant without complications. Despite the initial response to treatment, the disease progressed three months later. Molecular therapy was subsequently administered, but the patient ultimately succumbed 16 months after the initial diagnosis. Current guidelines do not recommend routine breast examinations during antenatal care; however, this case underscores the importance of breast evaluation during pregnancy as both a medical and psychological imperative.