Pune doctors have given a new lease of life by performing a life-saving right mastectomy on a 27-year-old woman who was 26 weeks pregnant after diagnosing her with high-grade sarcoma of the breast, a rare and aggressive form of breast cancer. The medical team successfully treated the mother while ensuring the safety of her unborn baby without terminating the pregnancy.
The team led by Dr Utkarsh Ajgaonkar, Consultant Surgical Oncologist, Dr. Madhura, Assistant Surgeon and anaesthesia team led by Dr Vishvas Koul, head of Anesthesia & Critical Care, TGH OncoLife Cancer Centre .
The woman, Soni Kumari, a 27-year-old tailor from Lonavala, was happily looking forward to welcoming her second child when a frightening health crisis overshadowed her joy. Nearly six months earlier, she had noticed a lump in her right breast but ignored it, assuming it was a normal pregnancy-related change while focusing on her family and pregnancy. When she developed a persistent fever for a week, and the wound became increasingly difficult to manage, her family rushed her to the hospital around three weeks ago. It initially seemed like a neglected breast lump turned out to be breast cancer, putting both the young mother’s life and her unborn baby’s future at risk.
Dr Ajgaonkar said, “The patient came to us with a rapidly enlarging breast tumour, a large infected wound measuring nearly 8 × 8 cm, and persistent fever. A biopsy confirmed a high-grade sarcoma of the breast, a rare and aggressive cancer. The exact cause of this rare breast sarcoma is usually idiopathic, meaning it develops without any identifiable cause. Breast sarcomas account for less than 1% of all breast cancers, and encountering this tumour during pregnancy is extraordinarily uncommon. The infection had progressed significantly, and there was a real risk that it could spread into the bloodstream, leading to sepsis or septic shock, which could have threatened both the mother’s life and the pregnancy. While chemotherapy is often considered for many cancers, it has a very limited role in this type of sarcoma, making surgery the only life-saving option. At the same time, pregnancy limited the use of several diagnostic investigations, including PET scans and other radiation-based imaging, making clinical judgment even more critical.”
He further added , “After extensive discussions with the patient and her family, our multidisciplinary team carefully planned every step of her treatment. The priority was to remove the source of infection before it progressed to life-threatening sepsis, while ensuring the pregnancy continued safely. To prevent sepsis, she underwent a right mastectomy on 2nd July, a surgery to remove the affected breast, as a life-saving procedure. The surgery was completed successfully within one hour, with continuous monitoring of the unborn baby and meticulous anaesthetic management to maintain the safety of both mother and child. One of the biggest challenges was to minimise the duration of surgery and anaesthesia to reduce the risk of fetal distress or premature delivery. The patient recovered well and was discharged in stable condition on July 4. Her antibiotics have been discontinued, and she will be closely monitored by our multidisciplinary team. She has attended two follow-up visits, where both the mother and the unborn baby were found to be doing well.”
Dr Koul said, “Providing anaesthesia to a pregnant woman undergoing major cancer surgery is highly challenging because the well-being of both the mother and the unborn baby must be protected simultaneously. Throughout the surgery, we continuously monitored the baby’s condition while carefully maintaining the mother’s blood pressure, oxygen levels, and overall stability. Close coordination between the anaesthesia, surgical, obstetric, and neonatal teams was crucial in ensuring a safe outcome.”
Dr Ajgaonkar explained, “High-grade sarcoma of the breast grows rapidly. Hence, early diagnosis and timely treatment are critical. The condition can easily be mistaken for more common breast lumps, making specialist evaluation essential, particularly when a breast lump enlarges quickly during pregnancy. She will remain in close follow-up to ensure the healthy progression of her pregnancy. Once the baby reaches a safe gestational age and is delivered, we will proceed with a PET scan to know if the cancer has spread to other parts of the body and further treatment, including chemotherapy or radiotherapy, if required.”
Expressing her gratitude, the woman said, “When I was told that I had breast cancer during my pregnancy, my world came crashing down. My biggest fear was whether I would lose my baby while fighting for my own life. The doctors at the hospital gave me hope when they assured me that they would do everything possible to protect both of us. Their support helped me stay strong through one of the most difficult phases of my life. Today, knowing that my baby is safe and recovering alongside me is the greatest blessing I could have asked for. I am now looking forward to welcoming my little one into this world and beginning a new chapter with my family. I will always be grateful to the entire team for saving not just my life, but my baby’s life as well.”