Pregnancy-associated breast cancer: strategies for safe and effective treatment. Narrative literature review

Objective: To analyze current strategies for the safe and effective treatment of pregnancy-associated breast cancer, highlighting current recommendations that optimize maternal-fetal outcomes. Methods: A systematic review of the literature was conducted by searching PubMed, Cochrane Library, Wiley Library, LILACS and SciELO, including studies in English and Spanish published between 2004 and 2024. Clinical trials, observational studies, systematic reviews and clinical practice guidelines on breast cancer treatment during pregnancy were analyzed. Results: 634 articles were identified, of which 79 met the inclusion criteria. The literature indicates that pregnancy-associated breast cancer is rare, but characterized by aggressive biological behavior. Its diagnosis is often delayed due to physiological changes in the pregnant breast and the lack of early imaging studies. Its treatment is multidisciplinary, based on surgery and chemotherapy starting from the second trimester, avoiding radiotherapy and targeted therapies until postpartum. Conclusions: Pregnancy-associated breast cancer is a clinical challenge that requires a comprehensive and coordinated approach. Timely treatment allows survival rates similar to those of non-pregnant women. More research is needed on safe targeted therapies during gestation.