Recurrence of triple negative breast cancer in a 34-year old female patient during the second pregnancy – a case report

A 34-year-old female patient at 36th week of her second pregnancy was admitted to the 1stDepartment of Obstetrics and Gynecology, Medical University of Warsaw. She had a cesarean section at 32nd week of her first multiple pregnancy in 2010. She had a history of bilateral mastectomy [a right breast in 2012, partially left breast (without neoplasia) in 2013] because of carcinoma mammae ER (-) PGR (-), HER 2 (1) according to Ventana (negative status). In the current pregnancy a cervical cerclage and pessary were inserted at 14th and 17th week of gestation, respectively. At 36 weeks she started suffering from increasing pain in the lumbar part of spine, unresponsive to medication . Due to pain and limited mobility she was qualified for an operative delivery under general anesthesia a baby boy of 3310g was born in good general condition. However, the pain did not regress after the delivery. In addition, pain of lower limbs appeared. 20 days after cesarean section PET CT was performed: metabolically active metastases were found in bones, lymph nodes (chest, abdomen, neck), in the right lung and pleura and the liver breast cancer recurrence. Additional X-ray of the right femur revealed a large metastasis requiring surgical treatment. The patient was referred for systemic treatment with a poor prognosis. She died 5 months after delivery.