Triple-Negative Breast Cancer in Pregnancy: A Case Report and Narrative Review of Multidisciplinary Management in a Resource-Limited Setting

Pregnancy-associated breast cancer (PABC) is a rare diagnosis, occurring in approximately 0.2–2.6% of pregnancies. Triple-negative breast cancer (TNBC) presents additional challenges due to its aggressive behavior and lack of targeted therapies. We report a 35-year-old gravida 2, para 1 woman diagnosed with TNBC at 19 weeks’ gestation. She presented with a progressively enlarging left breast and axillary mass, initially noted at five weeks pregnant. Imaging confirmed BI-RADS 5 lesions, and biopsy revealed triple-negative disease with high Ki-67. Multidisciplinary staging showed no metastases. Neoadjuvant chemotherapy with epirubicin and cyclophosphamide began at 19 weeks, followed by weekly paclitaxel from 22 to 34 weeks. Fetal growth and wellbeing were preserved throughout. This case highlights the safe administration of chemotherapy during the second trimester, aligning with international evidence. A narrative review of similar cases confirms favorable neonatal outcomes and maternal responses, with preterm delivery being the most frequent complication. Importantly, this case was managed in a resource-limited setting, demonstrating that effective care is feasible with coordinated multidisciplinary input. Systemic chemotherapy can be safely delivered during pregnancy when guided by a multidisciplinary team. This case adds to the limited literature on TNBC in pregnancy, particularly in low-resource environments.