Breast cancer during pregnancy
Authors:
Jiří Škultéty 1; Michael Jiří Halaška 1; Pavel Strnad 1; Lukáš Rob 1; Hana Stankušová 2
Authors place of work:
onkogynekologické oddělení, Gynekologicko-porodnická klinika 2. LF UK a FN v Motole, Praha, přednosta prof. MUDr. Lukáš Rob, CSc.
1; Onkologická klinika 2. LF UK a FN v Motole, Praha, přednostka doc. MUDr. Jana Prausová, Ph. D., MBA
2
Published in the journal:
Prakt Gyn 2014; 18(1): 42-46
Category:
Oncogynecology: Review Article
Summary
Breast cancer belongs in most common malignant diseases diagnosed during pregnancy. Incidence in Czech Republic is estimated to 10–30 in 100 000 pregnancies, including pregnancy associated breast cancer (breast cancer diagnosed within one year after delivery). Breast cancer is often diagnosed at advanced stages because of immitation of classical signs with normal changes in pregnant or lactating breast. Therefore each pregnant women should underwent examination of breasts with diagnose of pregnancy. The most appropriate imaging examination is ultrasonography, mammography can be used at first end second trimester with proper shielding of pregnant uterus. Use of scintigraphy in staging can be replaced by whole body MRI. Treatment should be planned by multidisciplinary team, including oncologist, radiotherapist, ob-gyn specialist, neonatologist, expectant mother and father of unborn child. All treatment modalities can be used – surgical approach, chemotherapy and in rare cases radiotherapy (by AAPM standards). Currently, the diagnosis of malignant disease during pregnancy is no longer automatic indication for termination of pregancy. Primary target of our treatment efforts is to avoid of preterm birth in lower gestations weeks, therefore higher risk of neonatal morbidity and mortality. Prognosis of pregnant patients with breast cancer is not different from nonpregnant.
Key words:
breast cancer – pregnancy – oncological treatment at pregnancy
Zdroje
1. Rob L, Halaska MJ. Gynaecological cancer in pregnancy. Textbook of Gynaecological Oncology. Gunes Publishing: Ankara 2009. ISBN: 978–975–277–267–0.
2. Ústav zdravotnických informací a statistiky ČR. Novotvary – 2010–ČR. Dostupné z WWW: <http://www.uzis.cz/category/tematicke-rady/zdravotnicka-statistika/novotvary>.
3. Hahn KM, Johnson PH, Gordon N et al. Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 2006; 107(6): 1219–1226.
4. Halaska MJ, Pentheroudakis G, Strnad P et al. Presentation, management and outcome of 32 patients with pregnancy-associated breast cancer: a matched controlled study. Breast J 2009; 15(5): 461–467.
5. Amant F, Deckers S, Van Calstern K et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer 2010; 46(18): 3158–3168.
6. Bellin MF, Webb JA, Van Der Molen AJ et al. Safety of MR liver specific contrast media. Eur Radiol 2005; 15(8): 1607–1614.
7. Moran BJ, Yano H, Al Zahir N et al. Conflicting priorities in surgical intervention for cancer in pregnancy. Lancet Oncol 2007; 8(6): 536–544.
8. Hershman DL, Wang X, McBride R et al. Delay in initiating adjuvant radiotherapy following breast conservation surgery and its impact on survival. Int J Radiat Oncol Biol 2006; 65(5): 1353–1360.
9. Gentilini O, Masullo M, Rotmensz N et al. Breast cancer diagnosed during pregnancy and lactation: biological features and treatment options. Eur J Surg Oncol 2005; 31(3): 232–236.
10. Kuerer HM, Gwyn K, Ames FC et al. Conservative surgery and chemotherapy for breast carcinoma during pregnancy. Surgery 2002; 131(1): 108–110.
11. Gentilini O, Cremonesi M, Trifiro G et al. Safety of sentinel node biopsy in pregnant patients with breast cancer. Ann Oncol 2004; 15(9): 1348–1351.
12. 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.
13. Amant F, Van Calsteren K, Halaska MJ et al. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol 2012; 13(3): 256–264.
14. Van Calsteren K, Verbesselt R, Beijnen J et al. Transplacental transfer of anthracyclines, vinblastine, and 4-hydroxy-cyclophosphamide in a baboon model. Gynecol Oncol 2010; 119(3): 594–600.
15. Van Calsteren K, Verbesselt R, Ottevanger N et al. Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study. Acta Obstet Gynecol Scand 2010; 89(10): 1338–1345.
16. Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol 2004; 5(5): 283–291.
17. Cardonick E, Dougherty R, Grana G. Breast cancer during pregnancy: maternal and fetal outcomes. Cancer J 2010; 16(1): 76–82.
18. Avilés A, Neri N. Hematological malignancies and pregnancy: a final report of 84 children who received chemotherapy in utero. Clin Lymphoma 2001; 2(3): 173–177.
19. Halaska MJ, Komar M, Vlk R et al. A pilot study on peak systolic velocity monitoring of fetal anemia after administration of chemotherapy during pregnancy. Eur J Obstet Gynecol Reporod Biol 2014; 174: 76–79.
20. Stovall M, Blackwell CR, Cundiff J et al. Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36. Med Phys 1995; 22(1): 63–82.
Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineČlánok vyšiel v časopise
Practical Gynecology
2014 Číslo 1
Najčítanejšie v tomto čísle
- Father on childbirth
- Specifics of ovarian cancer in patients with BRCA mutations: PARP Inhibitor Treatment in Ovarian and Breast Cancer
-
Hymen, Godsend or Curse?
Surgical Outpatient Hysteroscopy Using Vaginoscopic Access in Patients with Preserved Hymen - Thyroid cancer in pregnancy: case reports