This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: JIPMER 2018, Subject name: Surgery
All are management options for carcinoma breast in 2nd trimester except: 
Select and explain. 
A. Chemotherapy doxorubicin + cyclophosphamide + 5-FU, B. Mastectomy, C. Focal 3D, D. Breast conservative surgery is a valid option
C: Focal 3D
Answer: C: Focal 3D 
Explanation: Management of breast cancer in pregnancy: 1.Early invasive breast cancer: - Breast conservative surgery + Radiotherapy - Simple mastectomy + axillary lymph node sampling Pregnancy is a contra-indication for breast conservative surgery due to the radiotherapy which is followed after surgery. 2.Locally advanced breast cancer: - Neo-adjuvant chemotherapy + MRM + Radiotherapy Chemotherapy is not advised in 1st trimester because the cytotoxic drugs may cause congenital anomalies as organogenesis occurs in 1st trimester. Hence chemotherapy is usually given in 2nd trimester. Radiation therapy can be given after delivery. Focal 3D is not related to the management of breast cancer.