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Management of breast cancer in pregnancy

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The concurrent diagnosis of breast cancer and pregnancy remains a challenging clinical situation. Ethical concerns regarding maternal and fetal well-being and potential risks and harms of treatment influence the clinical decision process. Ethical considerations of treatment initiation have emphasized the role of autonomy for the patient and the concept of beneficence and non-maleficence for patient and fetus. Limited prospective data are available to assist the physician and patient in making an informed decision. Recent data on diagnosis, evaluation, and management of pregnant patients with breast cancer have informed the development of international recommendations and guidelines for management of breast cancer during pregnancy. This article reviews the epidemiology, clinical presentation, diagnosis, therapy, and outcomes of breast cancer occurring concomitantly with pregnancy.

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References and Recommended Reading

  1. 1.

    Chervenak FA, McCullough LB, Knapp RC, et al.:A clinically comprehensive ethical framework for offering and recommending cancer treatment before and during pregnancy.Cancer 2004,100:215–222.

  2. 2.

    McCullough LB, Coverdale JH, Chervenak FA:A comprehensive ethical framework for responsibly designing and conducting pharmacologic research that involves pregnant women.Am J Obstet Gynecol 2005,193:901–907.

  3. 3.

    Oduncu FS, Kimmig R, Hepp H, Emmerich B:Cancer in pregnancy: maternal-fetal conflict.J Cancer Res Clin Oncol 2003,129:133–46.

  4. 4.

    Smith LH, Dalrymple JL, Leiserowitz GS, et al.:Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997.Am J Obstet Gynecol 2001,184:1504–12.

  5. 5.

    Reis LA, Hankey BF, Miller, BA, et al.:Cancer Statistics Review 1973–1988. III.39, 91-2789. Bethesda, MD: National Cancer Institute; 1991.

  6. 6.

    White TT:Prognosis of breast cancer for pregnant and nursing women: analysis of 1,413 cases.Surg Gynecol Obstet 1955,700:661–666.

  7. 7.

    Saunders CM, Baum M:Breast cancer and pregnancy: a review.J R Soc Med 1993,86:162–165.

  8. 8.

    Nettleton J, Long J, Kuban D, et al.:Breast cancer during pregnancy: quantifying the risk of treatment delay.Obstet Gynecol 1996,87:414–448.

  9. 9.

    Rosene-Montella K, Larson L:Obstetric monitoring: maternal and fetal testing: diagnostic testing. InMedical Care of the Pregnant Patient. Edited by Lee RV, Rosene-Montella K, Barbour LA, et al. Philadelphia: American College of Physicians, 2000:103–116.

  10. 10.

    Liberman L, Giess C, Dershaw D, et al.:Imaging of pregnancy-associated breast cancer.Radiology 1994,191:245–8.

  11. 11.

    Samuels TH, Liu FF, Yaffe M, Haider M:Gestational breast cancer.Can Assoc Radiol J 1998,49:172–80.

  12. 12.

    Ahn BY, Kim HH, Moon WK, et al.:Pregnancy- and lactation-associated breast cancer: mammographic and sonographic findings.J Ultrasound Med 2003,22:491–497.

  13. 13.

    Yang WT, Dryden MJ, Gwyn K, et al.:Imaging of breast cancer diagnosed and treated with chemotherapy during pregnancy.Radiology 2006,239:52–60.

  14. 14.

    Gwyn K, Theriault R:Breast cancer during pregnancy.Oncology (Huntingt) 2001,15:39–46.

  15. 15.

    Talele AC, Slanetz PJ, Edmister WB, et al.:The lactating breast: MRI findings and literature review.Breast J 2003,9:237–240.

  16. 16.

    Middleton LP, Amin M, Gwyn K, et al.:Breast carcinoma in pregnant women: assessment of clinicopathologic and immunohistochemical features.Cancer 2003,98:1055–1060.

  17. 17.

    Hahn KM, Johnson PH, Gordon N, et al.:Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero.Cancer 2006,107:1219–26.

  18. 18.

    Giacalone P-L, Laffargue F, Benos P:Chemotherapy for breast carcinoma during pregnancy.Cancer 1999,86:2266–2272.

  19. 19.

    Ring AE, Smith IE, Ellis PA:Breast cancer and pregnancy.Ann Oncol. 2005,16:1855–1860.

  20. 20.

    Hanrahan EO, Theriault R:Pregnancy and breast cancer. InBreast Cancer, edn 2. Edited by Winchester DJ, Norton L, Winchester DP. Philadelphia: B. C. Decker, Inc.; 2006:1–14.

  21. 21.

    Gosfield E, Alavi A, Kneeland B:Comparison of radionuclide bone scans and magnetic resonance imaging in detecting spinal metastases.J Nucl Med 1993,34:2191.

  22. 22.

    Flickinger FW, Sanal SM:Bone marrow MRI: techniques and accuracy for detecting breast cancer metastases.Magn Reson Imaging 1994,12:829–835.

  23. 23.

    Kuerer HM, Gwyn K, Ames FC, Theriault RL:Conservative surgery and chemotherapy for breast carcinoma during pregnancy.Surgery 2002,131:108–110.

  24. 24.

    Annane K, Bellocq JP, Brettes JP, Mathelin C:Infiltrative breast cancer during pregnancy and conservative surgery.Fetal Diagn Ther 2005,20:442–444.

  25. 25.

    Kal HB, Struikmans H:Radiotherapy during pregnancy: fact and fiction.Lancet Oncol 2005,6:328–333.

  26. 26.

    Edge SB, Niland JC, Bookman MA, et al.:Emergence of sentinel node biopsy in breast cancer as standard-of-care in academic comprehensive cancer centers.J Natl Cancer Inst 2003,95:1514–1521.

  27. 27.

    Keleher A, Wendt R III, Delpassand E, et al.:The safety of lymphatic mapping in pregnant breast cancer patients using Tc-99m sulfur colloid.Breast J 2004,10:492–495.

  28. 28.

    Gentilini O, Cremonesi M, Trifiro G, et al.:Safety of sentinel node biopsy in pregnant patients with breast cancer.Ann Oncol 2004,15:1348–1351.

  29. 29.

    Amersi F, Hansen NM:The benefits and limitations of sentinel lymph node biopsy.Curr Treat Options Oncol 2006,7:141–151.

  30. 30.

    Rosenkranz KM, Lucci A:Surgical treatment of pregnancy associated breast cancer.Breast Dis 2005,23:87–93.

  31. 31.

    Ring AE, Smith IE, Jones A, et al.:Chemotherapy for breast cancer during pregnancy: an 18-year experience from five London teaching hospitals.J Clin Oncol 2005,23:4192–4197.

  32. 32.

    Germann N, Goffinet F, Goldwasser F:Anthracyclines during pregnancy: embryo-fetal outcome in 160 patients.Ann Oncol 2004,15:146–150.

  33. 33.

    Gonzalez-Angulo AM, Walters RS, Carpenter RJ Jr, Ross et al.:Paclitaxel chemotherapy in a pregnant patient with bilateral breast cancer.Clin Breast Cancer 2004,5:317–319.

  34. 34.

    Gainford MC, Clemons M:Breast cancer in pregnancy: are taxanes safe? Clin Oncol (R Coll Radiol.) 2006,18:159.

  35. 35.

    Romond EH, Suman VJ, Geyer CE Jr, et al.:Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer.N Engl J Med 2005,353:1673–1684.

  36. 36.

    Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al.:Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer.N Engl J Med 2005,353:1659–1672.

  37. 37.

    Fanale M, Uyei A, Theriault RL, et al.:Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy.Clin Breast Cancer 2005,6:354–356.

  38. 38.

    Watson WJ:Herceptin (trastuzumab) therapy during pregnancy: association with reversible anhydramnios.Obstet Gynecol 2005,105:642–643.

  39. 39.

    Waterston AM, Graham J:Effect of adjuvant trastuzumab on pregnancy.J Clin Oncol 2006,21:321–322.

  40. 40.

    Loibl S, von Minckwitz G, Gwyn K, et al.:Breast carcinoma during pregnancy. International recommendations from an expert meeting.Cancer 2006,106:237–246.

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Correspondence to Richard Theriault DO, MBA.

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Theriault, R., Hahn, K. Management of breast cancer in pregnancy. Curr Oncol Rep 9, 17 (2007).

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  • Ective Series
  • Ective Data
  • Uring Pregnancy
  • Detect Breast Cancer Metastasis