Sadaf Alipour (editor) - Diseases of the Breast during Pregnancy and Lactation
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- Book:Diseases of the Breast during Pregnancy and Lactation
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Diseases of the Breast during Pregnancy and Lactation: summary, description and annotation
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Symptoms of the breast in gravid women commonly represent physiological changes, however they may also be related to serious underlying breast disease; this challenging dilemma is aggravated by diagnostic and therapeutic limitations imposed by safety issues regarding the mother and fetus. A comprehensive coverage of all aspects of normal and pathologic breast changes during pregnancy and lactation, their diagnosis and management is provided in the present work.
This unique reference has been written by academic experts from different centers and diverse disciplines in a practical format. It is intended to be an ideal resource for every practitioner and specialist who manages complaints of gravid and nursing women or treats breast disorders in women of child bearing age.
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Advances in Experimental Medicine and Biology provides a platform for scientific contributions in the main disciplines of the biomedicine and the life sciences. This series publishes thematic volumes on contemporary research in the areas of microbiology, immunology, neurosciences, biochemistry, biomedical engineering, genetics, physiology, and cancer research. Covering emerging topics and techniques in basic and clinical science, it brings together clinicians and researchers from various fields. provides a platform for scientific contributions in the main disciplines of the biomedicine and the life sciences. This series publishes thematic volumes on contemporary research in the areas of microbiology, immunology, neurosciences, biochemistry, biomedical engineering, genetics, physiology, and cancer research. Covering emerging topics and techniques in basic and clinical science, it brings together clinicians and researchers from various fields.
Advances in Experimental Medicine and Biology has been publishing exceptional works in the field for over 40 years, and is indexed in SCOPUS, Medline (PubMed), Journal Citation Reports/Science Edition, Science Citation Index Expanded (SciSearch, Web of Science), EMBASE, BIOSIS, Reaxys, EMBiology, the Chemical Abstracts Service (CAS), and Pathway Studio. has been publishing exceptional works in the field for over 40 years, and is indexed in SCOPUS, Medline (PubMed), Journal Citation Reports/Science Edition, Science Citation Index Expanded (SciSearch, Web of Science), EMBASE, BIOSIS, Reaxys, EMBiology, the Chemical Abstracts Service (CAS), and Pathway Studio.
2019 Impact Factor: 2.450 5 Year Impact Factor: 2.324
More information about this series at http://www.springer.com/series/5584
This Springer imprint is published by the registered company Springer Nature Switzerland AG.
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To:My dear husband Farivar,And my lovely daughter Newsha.
Ramesh
To:Baba, Maman, and Marjan
Amirhossein, Yaas, and Noora
For the warm support they offer,
And the endless love they share.
Sadaf
Pregnancy should be a time of rejoicing for a woman and her partner with the thrill of a new birth to look forward to. After delivery, breast feeding allows bonding and provides the best source of nutrients for the baby. In a few patients, however, pregnancy does not come alone, and a womans biggest fear, breast cancer , develops in a few women at a time in their life when they should be optimistically looking toward the future. Also for some women, breastfeeding can be a challenge. Although breastfeeding seems the most natural thing in the world, I am not sure we are really honest with women about how challenging breastfeeding can be.
RP was a 30-year-old nurse. She was pregnant and was having problems with morning sickness. She went to her GP to get advice, and just as she was on the way out of the consultation, she mentioned rather as an afterthought that she had a breast lump. GP appointments in the UK are only 10 min, and the GP indicated that normally as it was another problem, she should make another appointment to have her breast lump assessed, but the GP at that visit did perform a breast examination and confirmed a lump, reassuring that the lump felt benign. A routine referral to see a breast surgeon was made. Two weeks later, RP attended a breast clinic where a breast lump measuring 30 mm was confirmed, and while a fibroadenoma was considered the most likely, a core biopsy was performed. The pathology showed the lump was a triple-negative breast cancer and as RP was only 20 weeks pregnant. Chemotherapy was then started, and she was referred to genetics. The response to chemotherapy was good, but the gene test showed an abnormality in BRCA1, and this was thought likely pathogenic. Chemotherapy was completed, the baby was delivered, and then surgery followed. A bilateral mastectomy with reconstruction was performed after discussion of the implications of the BRCA1 abnormality. Within the breasts , there was no residual disease at the site of the initial cancer after chemotherapy . RP had a good cosmetic outcome from her surgery , and all wounds healed. She coped amazingly well during what was a hugely stressful time. Her baby was bottle-fed and thrived. Given the wish for more children, a decision was taken by RP and her husband to have IVF with preimplantation genetic testing to ensure any subsequent children did not carry the BRCA1 gene abnormality. It was during this time that the genetics team contacted RP with updated information, which had now concluded the genetic abnormality in BRCA1 present in RP had been downgraded to a variant of unknown significance. RP found this news devastating and confusing. Explaining what the downgrading meant as a risk to RP and her daughter took time and numerous visits, and slowly, RP understood this was good news in that her daughter was no longer at increased risk and the downgrading meant that she could keep her ovaries. For patients like this, a huge team of professionals is involved in treating and supporting her through very difficult times. At a time when she was just getting her life on track, RP found the news about the downgrade to be a huge psychological blow.
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