skip to main content

Pregnancy-associated Breast Cancer — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardBreast CancerPregnancy-associated Breast CancerSCE Medical Oncology

A woman at 18 weeks of pregnancy has operable node-positive HER2-positive breast cancer and wishes to continue the pregnancy. Which treatment sequence is most appropriate after multidisciplinary discussion?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Give indicated surgery and second-trimester anthracycline chemotherapy; defer HER2 therapy and radiotherapy until after birth

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

C is correct. RCOG guidance allows breast surgery throughout pregnancy and systemic chemotherapy from the second trimester when clinically indicated. HER2-directed therapy is ordinarily deferred because later-trimester exposure is associated with oligohydramnios or anhydramnios and fetal toxicity; radiotherapy is also deferred. Delaying all effective treatment can compromise maternal outcome. Trastuzumab is not a safer substitute for chemotherapy during gestation, and radiotherapy is not used in place of definitive surgery. The delivery and chemotherapy-stop interval require joint obstetric, neonatal and oncology planning.

Reference: RCOG Green-top Guideline 12 pregnancy and breast cancer: https://pubmed.ncbi.nlm.nih.gov/40855616/