Although a rare and challenging condition, cancer during pregnancy should promptly be identified and treated. Not only standards of care guidelines for the underlying disease are taken into account, but also fetal safety might be weighted for clinical decisions. Frequent lack of experience and knowledge about this condition could lead to late diagnosis, imprecise management, suboptimal treatment and fetal and maternal harm. Therefore, this review aims to summarize the current evidence regarding the epidemiology, clinical presentation, diagnostic workup, staging and treatment, including novel treatment modalities for patients diagnosed with cancer during pregnancy.

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Background Breast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. Controversy remains about its impact on the preoperative staging of breast cancer surgery. This study evaluated survival and surgical outcomes of preoperative MRI in conservative breast cancer surgery. Methods A phase III, randomized, open-label, single-center trial including female breast cancer participants, stage 0–III disease, and eligible for breast-conserving surgery. We compared the role of including MRI in preoperative evaluation versus radiologic exam routine with mammography and ultrasound in breast cancer conservative candidates. The primary outcome was local relapse-free survival (LRFS), and secondary outcomes were overall survival (OS), mastectomy rate, and reoperation rate. Results 524 were randomized to preoperative MRI group (n = 257) or control group (n = 267). The survival analysis showed a 5.9-years LRFS of 99.2% in MRI group versus 98.9% in control group (HR = 0.72; 95% CI 0.12—4.28; p = 0.7) and an OS of 95.3% in the MRI group versus 96.3% in the control group (HR = 1.37 95% CI 0.59–3.19; p = 0.8). Surgical management changed in 21 ipsilateral breasts in the MRI group; 21 (8.3%) had mastectomies versus one in the control group. No difference was found in reoperation rates, 22 (8.7%) in the MRI group versus 23 (8.7%) in the control group (RR = 1.002; 95% CI 0.57–1.75; p = 0.85). Conclusion Preoperative MRI increased the mastectomy rates by 8%. The use of preoperative MRI did not influence local relapse-free survival, overall survival, or reoperation rates.

Objective: Samples from breast nipples collected with the automated HALO™ Mamo Cito Test were studied in order to evaluate the cellularity for the diagnosis of breast cancer. Study Design: One hundred and fifty-nine asymptomatic women were prospectively examined. Women younger than 18 years, pregnant or lactating women, and women with a history of breast cancer, with previous radio- or chemotherapy and with nipple piercing were excluded from the study. Nipple samples from both breasts were collected. Results: In 107 (34.96%) of the 306 samples of nipple discharge analyzed by optical microscopy, adequate cellularity was observed after the HALO procedure. Cytological findings, previously categorized according to the National Health Service Breast Screening Program (NHSBSP), were grouped as unsatisfactory, benign, suspected for malignancy, and malignant. Of the cellular breast samples, 97.19% (104/107) were classified as benign, and 2.81% (3/107) were classified as suspicious for malignancy. In 199 cases there were samples without cells (65.03%). Most of the cells observed were easily recognized as well-preserved and adequately stained macrophages. None of the women reported discomfort with the nipple aspiration procedure. Conclusions: The results discussed here encouraged us to use samples collected automatically in routine procedures.