Pregnancy pains.

Navigating the complexities of a breast cancer diagnosis during pregnancy often calls for joint expertise. Luckily, there have been a couple of insightful publications this year addressing this challenging scenario. Researchers at University of North Carolina (UNC) produced expert guidelines which lean on a comprehensive lit review. To hit the high points: mammogram and ultrasound are ok while CT and gadolinium are not, (notwithstanding a need for creative approaches to locoregional anesthesia) no surgical recommendations change, (surprisingly) no cytotoxic chemo recs change after the first trimester, and radiation/endocrine/HER2-targeted therapies should be avoided. Ok, great. So how can we counsel these women on outcomes? A large Canadian retrospective cohort analysis this year indicates that a pregnancy concurrent with or following a breast cancer diagnosis did not significantly impact (excellent) overall survival outcomes. Which is perhaps unsurprising given the few limitations on the most impactful life-prolonging therapy of all--chemo. Hopefully these stats can help alleviate the pain of delivering a breast cancer diagnosis peri-positive pregnancy test.