Anti-D and anti-c levels should be measured every 4 weeks up to 28 weeks of gestation and then every 2 weeks until delivery.

Sentinel node assessment using radioisotope scintigraphy does not cause significant uterine
radiation,but blue dye is not recommended as the effect upon the fetus is unknown. The most commonly used technique of sentinel node sampling uses both a radioactive tracer as well as blue dye, usually isosulfan blue.

Sentinel node biopsy is indicated in women who have a negative result from a preoperative axillary ultrasound and needle biopsy. If the axilla is positive, axillary clearance is indicated.

Women presenting with a breast lump during pregnancy should be referred to a breast specialist team and any imaging or further tests should be conducted within the breast multidisciplinary team.

• Ultrasound is used first to assess a discrete lump.
• But if cancer is confirmed, mammography is necessary (with fetal shielding) to assess the extent of disease and the contralateral breast.
• Tissue diagnosis is with ultrasound-guided biopsy for histology rather than cytology, as proliferative change during pregnancy renders cytology inconclusive in many women

The reported incidence of suture migration is about 7% and this can be reduced by trimming the suture ends and burying the knots in the deep and superficial perineal muscles.

Pregnancy itself does not appear to worsen the prognosis for women diagnosed in pregnancy.

However,as pregnancy-associated breast cancer occurs in a younger population who may have features that carry a higher risk of metastases such as high-grade tumours and estrogen receptor negative tumours, these younger women may be expected to have an inferior prognosis.

Women are generally advised to wait for at least 2 years after treatment for breast cancer before conception because of the risk of early relapse.

For partial thickness (all 3a and some 3b) tears, an end-to-end technique should be used.