# Breast Cancer During Pregnancy and Lactation: A Five-Year Retrospective Study in Sudan

## TL;DR

This study examines breast cancer cases diagnosed during pregnancy or lactation in Sudan, highlighting diagnostic challenges and the importance of early detection.

## Contribution

A five-year retrospective analysis of PABC cases in Sudan, providing insights into clinical presentations and risk factors specific to this population.

## Key findings

- Most patients presented with a palpable breast lump, followed by pain and skin changes.
- Invasive ductal carcinoma was the most common histopathological diagnosis.
- A significant proportion of cases were ER/PR-negative and HER2-negative.

## Abstract

Introduction

Breast cancer diagnosed during pregnancy or within the first year postpartum is termed pregnancy-associated breast cancer (PABC), and it is the most common malignancy occurring during pregnancy.

Objective

The objective of this study was to investigate the characteristics of breast cancer patients diagnosed during pregnancy and lactation at Wad-Madani Teaching Hospital, Sudan, from 2017 to 2022.

Methods

A retrospective, cross-sectional study was conducted, screening 2,151 breast cancer patients. After applying age and menopausal status exclusions, 33 patients (2.69% of eligible patients) who experienced symptom onset during pregnancy or lactation were included. Data on demographics, clinical presentation, risk factors, receptor status, and histopathology were collected from hospital records.

Results

The most common clinical presentation was a palpable breast lump (31/33, 93.9%), followed by breast pain (12/33, 36.4%) and skin changes or ulceration (10/33, 30.3%). Inflammatory features were present in 11 patients (33.3%). Obesity (9/33, 27.3%) and early menarche (10/33, 30.3%) were prevalent risk factors. Histopathological analysis revealed invasive ductal carcinoma (IDC) in 28 patients (84.8%). Regarding receptor status, 21 patients (63.6%) were estrogen/progesterone receptor (ER/PR)-negative, and 24 patients (72.7%) were human epidermal growth factor-2 (HER2)-negative.

Conclusion

Physiological changes during pregnancy and lactation complicate breast cancer detection and diagnosis. These findings underscore the need for heightened clinical suspicion, early investigation of breast symptoms, and a multidisciplinary approach to improve outcomes in this patient population.