Pregnancy-associated Breast Cancer
Authors:
P. Tesařová
Authors place of work:
Onkologická klinika 1. LF UK a VFN v Praze
Published in the journal:
Klin Onkol 2016; 29(Supplementum 3): 16-22
Category:
Review
doi:
https://doi.org/10.14735/amko20163S16
Summary
Pregnancy-associated breast cancer is defined as carcinoma diagnosed during pregnancy or breastfeeding, up to a year after delivery. Pregnant patients with breast cancer can be treated using procedures for non-pregnant patients, with some modifications designed to avoid damage to the fetus. Breastfeeding breast cancer patients need to stop immediately. Abortion before start of treatment or during therapy does not increase survival of these patients. Chemotherapy of breast cancer may start roughly from the second month of pregnancy. Effective treatment with anthracyclines, taxanes, and cisplatin is relatively safe for both mother and fetus. During pregnancy, patients can undergo surgery but are unable to undergo radiotherapy. Also, hormonal therapy and trastuzumab treatment is not safe for pregnant women with breast cancer. Prognosis of pregnant breast cancer patients is similar to non-pregnant patients. Worse prognosis was noted for breast cancer patients diagnosed during breastfeeding. After the cancer treatment is finished, breastfeeding is completely safe, but technical reasons it can usually only be done using the contra-lateral breast. Children of mothers who were treated for breast cancer during pregnancy do not show any worsening of physical and psychiatric parameters of development. Pregnancy following treatment for breast cancer does not affect the patient’s prognosis in a negative way, according to clinical studies, not even in patients who suffered from a hormonal-dependent carcinoma.
Key words:
breast cancer – pregnancy – breastfeeding – chemotherapy – radiotherapy – biological treatment – hormonal therapy
The author declares she has no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted:
10. 7. 2016
Accepted:
20. 7. 2016
Zdroje
1. Stensheim H, Møller B, van Dijk T et al. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009; 27 (1): 45–51. doi: 10.1200/JCO.2008.17.4110.
2. Johannsson O, Loman N, Borg A et al. Pregnancy-associated breast cancer in BRCA1 and BRCA2 germline mutation carriers. Lancet 1998; 352 (9137): 1359–1360.
3. Lambe M, Hsieh C, Trichopoulos D et al. Transient increase in the risk of breast cancer after giving birth. N Engl J Med 1994; 331 (1): 5–9.
4. Middleton LP, Amin M, Gwyn K et al. Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features. Cancer 2003; 98 (5): 1055–1060.
5. Lethaby AE, O‘Neill MA, Mason BH et al. Overall survival from breast cancer in women pregnant or lactating at or after diagnosis. Auckland Breast Cancer Study Group. Int J Cancer 1996; 67 (6): 751–755.
6. Collins JC, Liao S, Wile AG. Surgical management of breast masses in pregnant women. J Reprod Med 1995; 40 (11): 785–788.
7. Yang WT, Dryden MJ, Gwyn K et al. Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy. Radiology 2006; 239 (1): 52–60.
8. Talele AC, Slanetz PJ, Edmister WB et al. The lactating breast: MRI findings and literature review. Breast J 2003; 9 (3): 237–240.
9. Nicklas AH, Baker ME. Imaging strategies in the pregnant cancer patient. Semin Oncol 2000; 27 (6): 623–632.
10. Baker J, Ali A, Groch MW et al. Bone scanning in pregnant patients with breast carcinoma. Clin Nucl Med 1987; 12 (7): 519–524.
11. PDQ Adult Treatment Editorial Board. Breast Cancer Treatment and Pregnancy (PDQ®): Health Professional Version. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US): 2002–2014.
12. Duncan PG, Pope WD, Cohen MM et al. Fetal risk of anesthesia and surgery during pregnancy. Anesthesiology 1986; 64 (6): 790–794.
13. Annane K, Bellocq JP, Brettes JP et al. Infiltrative breast cancer during pregnancy and conservative surgery. Fetal Diagn Ther 2005; 20 (5): 442–444.
14. Kal HB, Struikmans H. Radiotherapy during pregnancy: fact and fiction. Lancet Oncol 2005; 6 (5): 328–333.
15. Greskovich JF Jr, Macklis RM. Radiation therapy in pregnancy: risk calculation and risk minimization. Semin Oncol 2000; 27 (6): 633–645.
16. Schwartz GF, Giuliano AE, Veronesi U. Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast, April 19–22, 2001, Philadelphia, Pennsylvania. Cancer 2002; 94 (10): 2542–2551.
17. Filippakis GM, Zografos G. Contraindications of sentinel lymph node biopsy: are there any really? World J Surg Oncol 2007; 5: 10.
18. Gentilini O, Cremonesi M, Trifirò G et al. Safety of sentinel node biopsy in pregnant patients with breast cancer. Ann Oncol 2004; 15 (9): 1348–1351.
19. Khera SY, Kiluk JV, Hasson DM et al. Pregnancy-associated breast cancer patients can safely undergo lymphatic mapping. Breast J 2008; 14 (3): 250–254. doi: 10.1111/j.1524-4741.2008.00570.x.
20. Amant F, Vandenbroucke T, Verheecke M et al. Pediatric outcome after maternal cancer diagnosed during pregnancy. N Engl J Med 2015; 373 (19): 1824–1834. doi: 10.1056/NEJMoa1508913.
21. Cardonick E, Gilmandyar D, Somer RA. Maternal and neonatal outcomes of dose-dense chemotherapy for breast cancer in pregnancy. Obstet Gynecol 2012; 120 (6): 1267–1272. doi: http: //10.1097/AOG.0b013e31826c32d9.
22. Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol 2004; 5 (5): 283–291.
23. Raphael J, Trudeau ME, Chan K. Outcome of patients with pregnancy during or after breast cancer: a review of the recent literature. Curr Oncol 2015; 22 (Suppl 1): S8–S18. doi: 10.3747/co.22.2338.
24. Nettleton J, Long J, Kuban D et al. Breast cancer during pregnancy: quantifying the risk of treatment delay. Obstet Gynecol 1996; 87 (3): 414–418.
25. Durodola JI. Administration of cyclophosphamide during late pregnancy and early lactation: a case report. J Natl Med Assoc 1979; 71 (2): 165–168.
26. Siu BL, Alonzo MR, Vargo TA et al. Transient dilated cardiomyopathy in a newborn exposed to idarubicin and all-trans-retinoic acid (ATRA) early in the second trimester of pregnancy. Int J Gynecol Cancer 2002; 12: 399–402.
27. Mir O, Berveiller P, Goffinet F et al. Taxanes for breast cancer during pregnancy: a systematic review. Ann Oncol 2010; 21 (2): 425–426. doi: 10.1093/annonc/mdp517.
28. Zagouri F, Sergentanis TN, Chrysikos D et al. Trastuzumab administration during pregnancy: a systematic review and meta-analysis. Breast Cancer Res Treat 2013; 137 (2): 349–357. doi: 10.1007/s10549-012-2368-y.
29. Kelly H, Graham M, Humes E et al. Delivery of a healthy baby after first-trimester maternal exposure to lapatinib. Clin Breast Cancer 2006; 7 (4): 339–341.
30. Isaacs RJ, Hunter W, Clark K. Tamoxifen as systemic treatment of advanced breast cancer during pregnancy – case report and literature review. Gynecol Oncol 2001; 80 (3): 405–408.
31. Anderka M, Mitchell AA, Louik C et al. Medications used to treat nausea and vomiting of pregnancy and the risk of selected birth defects. Birth Defects Res A Clin Mol Teratol 2012; 94 (1): 22–30. doi: 10.1002/bdra.22 865.
32. Schibler KR, Osborne KA, Leung LY et al. A randomized, placebo-controlled trial of granulocyte colony-stimulating factor administration to newborn infants with neutropenia and clinical signs of early-onset sepsis. Pediatrics 1998; 102 (1): 6–13.
33. Amant F, von Minckwitz G, Han SN et al. Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study. J Clin Oncol 2013; 31 (20): 2532–2539. doi: 10.1200/JCO.2012.45.6335.
34. Litton JK, Warneke CL, Hahn KM et al. Case control study of women treated with chemotherapy for breast cancer during pregnancy as compared with nonpregnant patients with breast cancer. Oncologist 2013; 18 (4): 369–376. doi: 10.1634/theoncologist.2012-0340.
35. Azim HA Jr, Santoro L, Russell-Edu W et al. Prognosis of pregnancy-associated breast cancer: a meta-analysis of 30 studies. Cancer Treat Rev 2012; 38 (7): 834–842. doi: 10.1016/j.ctrv.2012.06.004.
36. Murthy RK, Theriault RL, Barnett CM et al. Outcomes of children exposed in utero to chemotherapy for breast cancer. Breast Cancer Res 2014; 16 (6): 500. doi: 10.1186/s13058-014-0500-0.
37. Dessolle L, Dalmon C, Roche B et al. Placental metastases from maternal malignancies: review of the literature. J Gynecol Obstet Biol Reprod (Paris) 2007; 36 (4): 344–353.
38. Moran MS, Colasanto JM, Haffty BG et al. Effects of breast-conserving therapy on lactation after pregnancy. Cancer J 2005; 11 (5): 399–403.
39. Kroman N, Jensen MB, Wohlfahrt J et al. Pregnancy after treatment of breast cancer – a population-based study on behalf of Danish Breast Cancer Cooperative Group. Acta Oncol 2008; 47 (4): 545–549. doi: 10.1080/02841860801935491.
40. Azim HA Jr, Santoro L, Pavlidis N et al. Safety of pregnancy following breast cancer diagnosis: a meta-analysis of 14 studies. Eur J Cancer 2011; 47 (1): 74–83. doi: 10.1016/j.ejca.2010.09.007.
41. České matky stárnou. Statistika&My. [online]. Dostupné z: http: //www.statistikaamy.cz/2014/03/ceske-matky-starnou/.
42. Azim HA Jr, Botteri E, Renne G et al. The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study. Acta Oncol 2012; 51 (5): 653–661. doi: 10.3109/0284186X.2011.636069.
Štítky
Paediatric clinical oncology Surgery Clinical oncologyČlánok vyšiel v časopise
Clinical Oncology
2016 Číslo Supplementum 3
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
- Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
Najčítanejšie v tomto čísle
- Treatment with Aromatase Inhibitors in Postmenopausal Women with Breast Cancer and the Possibility of Influencing Side Effects
- Breast Cancer – Specifics of Gynecological Care and Counseling
- Circulating Levels of Estradiol in Breast Cancer Patients Treated with Aromatase Inhibitors and Their Clinical Implications
- Pregnancy after Treatment of Breast Cancer