Atypical Lesions of the Breast and Lobular Carcinoma in Situ in Pregnancy – Surgeons’ Practice

Abstract

Objective: Approach to precancerous and high-risk breast lesions occurring in pregnancy has received little attention in the literature. We carried out astudy to investigate the practice of surgeons in the management of these cases.Materials and Methods: A short survey was sent to surgeons, including a multiple-choice questionnaire about their practice for atypical hyperplasiaor lobular carcinoma in situ presenting in each trimester of pregnancy or at time of breastfeeding. Answer options included observation, immediate vacuumbiopsy, immediate surgery, surgery in next trimester, surgery after delivery, and surgery after end of breastfeeding; based on the time of presentation.Results: Out of the 671 practitioners invited, 97(14.5 %) responded to the survey. Participants were from 23 countries. Answers showed that managementof gestational Atypical Ductal Hyperplasia (ADH) and Lobular Neoplasia (LN) was readily postponed by surgeons in favor of fetus safety while beingcautious about risks of conservative management alone.Conclusion: Various methods of treatment are selected by surgeons for managing high-risk breast lesions during pregnancy. In the absence of relevantliterature, decision making in a multidisciplinary team would be the best approach in these cases.