Jul 04, 2025
Pregnancy-associated breast cancer (PABC) refers to breast cancer diagnosed during pregnancy or within one year postpartum, with an incidence of (2.4 to 7.3) cases per 100,000 pregnancies. Regarding the treatment of PABC, the international medical community currently believes that while continuing the pregnancy, necessary surgery and chemotherapy should be performed for the breast cancer, but the patient's and foetus's vital signs and changes in condition must be closely monitored throughout the entire process.
Chen Peng et al. mentioned in their paper "Application of electrosurgical equipment in operative treatment of PABC and the discuss of its safety guarantee" that a case of a 27-year-old PABC patient admitted to the Central Hospital of Cangzhou City, Hebei Province. The patient presented with a right breast mass discovered at 33 weeks of gestation, 10 days prior to admission. Outpatient bilateral breast ultrasound revealed a hypoechoic mass in the right breast (BI-RADS 4b category) and enlarged right axillary lymph nodes, with an initial diagnosis of right breast cancer. Electrosurgical equipment was used to perform a modified radical mastectomy. Prior to the procedure, the patient and her family were consulted multiple times, and they strongly expressed their desire to preserve the pregnancy. A multidisciplinary consultation involving the breast surgery, obstetrics, and anaesthesiology departments found no significant contraindications for surgery. Therefore, the procedure was conducted under general anaesthesia with continuous fetal heart monitoring.
In conventional surgery, procedures such as free flap dissection, total mastectomy, and axillary lymph node dissection all utilise monopolar high-frequency electrosurgical instruments. The principle of operation of monopolar high-frequency electrosurgical instruments is as follows: the high-frequency current from the electrosurgical instrument is applied to the human body via the electrosurgical pencil, producing cutting or coagulation effects. The current is conducted through the human body and returns to the electrosurgical equipment via the return negative electrode. To minimise the impact of using the high-frequency electrosurgical knife on the patient, a low-frequency cutting mode at 35 kHz and a low-frequency electrocoagulation mode at 30 kHz are employed. At the same frequency, these modes cause the least damage to both the mother and the foetus.
Conventional modified radical mastectomy (MRM) for breast cancer typically does not involve the use of bipolar forceps. However, due to the specific condition of this patient, bipolar coagulation was employed during flap dissection and hemostasis, as well as in the handling of small vessels and lymphatics, effectively reducing the use of monopolar electrosurgery. The technique demonstrated reliable hemostasis, minimizing the need for ligatures.
Based on intraoperative data, standard MRM performed with minimal use of electrosurgical devices generally requires around 95 minutes with an average blood loss of approximately 50 ml. In contrast, the PABC (Pregnancy-Associated Breast Cancer) patient in this study underwent surgery with the same approach and extent of dissection, yet the operative time was reduced to 80 minutes and blood loss to about 30 ml. The appropriate use of electrosurgical tools clearly contributed to this improvement.
Follow-up at 10 days postoperatively showed good flap perfusion at the incision site, with normal color and volume of axillary drainage and no significant surgical complications.
ShouLiang-med’s high-frequency surgical system offers multiple cutting and coagulation modes, meeting the low-frequency energy needs required for MRM in PABC patients. This supports shorter operative times and reduced blood loss, contributing to maternal-fetal safety. In addition, ShouLiang-med’s monopolar and bipolar instruments are made with high-quality non-stick materials, further minimizing the risk of tissue adhesion during surgery.
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