Advertisement

Breast Disease pp 349-357 | Cite as

Breast Cancer in Pregnancy

  • Maurício Magalhães Costa
  • Paula Saldanha
Chapter

Abstract

Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during gestation, lactation, or the first postpartum year. PABC is rare but extremely serious. The disease puts the lives of both mother and fetus at risk. In addition, PABC typically causes clinical, ethical, and psychological problems as well as doubts related to diagnosis and treatment. Clinical and ethical obstacles are frequently encountered during treatment. The gestational age is critical regarding therapeutic options, causing constant modifications and procedural delays. Surgical treatment can be undertaken during any phase of the pregnancy. Chemotherapy can potentially be administered during the second or third trimester. Radiotherapy is reserved for the postpartum period. Interruption of the gestation does not affect the treatment; however, it undoubtedly facilitates the therapeutic conduct. The indication of this course of action must be undertaken with great consideration and discussed openly with the patient and her family.

Keywords

Breast cancer Pregnancy Surgical treatment Fertility preservation 

References

  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics 2017. CA Cancer J Clin. 2017;67:7–30.PubMedGoogle Scholar
  2. 2.
    Matias M. Epidemiologia. In: Magalhães Costa M, Novais Dias E, Salvador Silva H, Figueira A, editors. Câncer de Mama para Ginecologistas. São Paulo: Editora Revinter; 1994.Google Scholar
  3. 3.
    Tabung FK, Steck SE, Liese AD, Zhang J, Ma Y, Caan B, et al. Association between dietary inflammatory potential and breast cancer incidence and death: results from the Women’s Health Initiative. Br J Cancer. 2016;114(11):1277–85.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Keinan-Boker L, Lerner-Geva L, Kaufman B, Meirow D. Pregnancy-associated breast cancer. Isr Med Assoc J. 2008;10(10):722–7.PubMedGoogle Scholar
  5. 5.
    Loibl S, Minckwitz GV, Gwyn K, Ellis P, Blohmer JU, Schlegelberger BM, et al. Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer. 2006;106(2):237–46.PubMedGoogle Scholar
  6. 6.
    Haagensen CD, Stout AP. Carcinoma of the breast: II. Criteria of operability. Ann Surg. 1943;118(5):859–70.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Westberg SV. Prognosis of breast cancer for pregnant and nursing women. Acta Obstet Gynecol Scand. 1946;25:1–239.Google Scholar
  8. 8.
    Haagensen CD. Cancer of the breast in pregnancy and during lactation. Am J Obstet Gynecol. 1967;98(1):141–9.PubMedGoogle Scholar
  9. 9.
    Amant F, Deckers S, Van Calsteren K, Loibl S, Halaska M, Brepoels L, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer. 2010;46(18):3158–68.PubMedGoogle Scholar
  10. 10.
    White TT. Carcinoma of the breast and pregnancy; analysis of 920 cases collected from the literature and 22 new cases. Ann Surg. 1954;139(1):9–18.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Wallack MK, Wolf JA Jr, Bedwinek J, Denes AE, Glasgow G, Kumar B, et al. Gestational carcinoma of the female breast. Curr Probl Cancer. 1983;7(9):1–58.PubMedGoogle Scholar
  12. 12.
    Birks DM, Crawford GM, Ellison LG, Johnstone FR. Carcinoma of the breast in women 30 years of age or less. Surg Gynecol Obstet. 1973;137(1):21–5.PubMedGoogle Scholar
  13. 13.
    Richards SR, Chang F, Moynihan V, O’Shaughnessy R. Metastatic breast cancer complicating pregnancy. J Reprod Med. 1984;29(3):211–3.PubMedGoogle Scholar
  14. 14.
    Max MH, Klamer TW. Pregnancy and breast cancer. South Med J. 1983;76:1008–90.Google Scholar
  15. 15.
    Nettleton J, Long J, Kuban D, Wu R, Shaefffer J, El-Mahdi A. Breast cancer during pregnancy: quantifying the risk of treatment delay. Obstet Gynecol. 1996;87(3):414–8.PubMedGoogle Scholar
  16. 16.
    Woo JC, Yu T, Hurd TC. Breast cancer in pregnancy: a literature review. Arch Surg. 2003;138:91–8.PubMedGoogle Scholar
  17. 17.
    Shellock FG, Crues JV. MR procedures: biologic effects, safety, and patient care. Radiology. 2004;232(3):635–52.PubMedGoogle Scholar
  18. 18.
    Leyendecker JR, Gorengaut V, Brown JJ. MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period. Radiographics. 2004;24(5):1301–16.PubMedGoogle Scholar
  19. 19.
    Cordeiro CN, Gemignani ML. Breast cancer in pregnancy: avoiding fetal harm when maternal treatment is necessary. Breast J. 2017;23(2):200–5.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Amant F, Loibl S, Neven P, Van Calsteren K. Breast cancer in pregnancy. Lancet. 2012;379:570–9.PubMedGoogle Scholar
  21. 21.
    Dequanter D, Hertens D, Veys I, Nogaret JM. Breast cancer and pregnancy. Review of the literature. Gynecol Obstet Fertil. 2001;29(1):9–14.PubMedGoogle Scholar
  22. 22.
    Antoniou AC, Shenton A, Maher ER, Watson E, Woodward E, Lalloo F, et al. Parity and breast cancer risk among BRCA1 and BRCA2 mutation carriers. Breast Cancer Res. 2006;8(6):R72.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Cullinane CA, Lubinski J, Neuhausen SL, Ghadirian P, Lynch HT, Isaacs C, et al. Effect of pregnancy as a risk factor for breast cancer in BRCA1/BRCA2 mutation carriers. Int J Cancer. 2005;117(6):988–91.PubMedGoogle Scholar
  24. 24.
    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):S8–18.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Petrek JA. Breast cancer and pregnancy. J Natl Cancer Inst Monogr. 1994;16:113–21.Google Scholar
  26. 26.
    Pandit-Taskar N, Dauer LT, Montgomery L, St Germain J, Zanzonico PB, Divgi CR. Organ and fetal absorbed dose estimates from 99mTc-sulfur colloid lymphoscintigraphy and sentinel node localization in breast cancer patients. J Nucl Med. 2006;47(7):1202–8.PubMedGoogle Scholar
  27. 27.
    Filippakis GM, Zografos G. Contraindications of sentinel lymph node biopsy: are there any really? World J Surg Oncol. 2007;5:10.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Gallenberg MM, Loprinzi CL. Breast cancer and pregnancy. Semin Oncol. 1989;16:369–76.PubMedGoogle Scholar
  29. 29.
    Kal HB, Struikmans H. Radiotherapy during pregnancy: fact and fiction. Lancet Oncol. 2005;6(5):328–30.PubMedGoogle Scholar
  30. 30.
    Barni S, Ardizzoia A, Zanetta G, Strocchi E, Lissoni P, Tancini G. Weekly doxorubicin chemotherapy for breast cancer in pregnancy. A case report. Tumori. 1992;78(5):349–50.PubMedGoogle Scholar
  31. 31.
  32. 32.
    Mir O, Berveiller P, Goffinet F, Treluyer JM, Serreau R, Goldwasser F, Rouzier R. Taxanes for breast cancer during pregnancy: a systematic review. Ann Oncol. 2010;21(2):425–6.PubMedGoogle Scholar
  33. 33.
    Shrim A, Garcia-Bournissen F, Maxwell C, Farine D, Koren G. Trastuzumab treatment for breast cancer during pregnancy. Can Fam Physician. 2008;54(1):31–2.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Zagouri F, Sergentanis TN, Chrysikos D, Papadimitriou CA, Dimopoulos MA, Bartsch R. Trastuzumab administration during pregnancy: a systematic review and meta-analysis. Breast Cancer Res Treat. 2013;137(2):349–57.PubMedGoogle Scholar
  35. 35.
    Kelly H, Graham M, Humes E, Dorflinger LJ, Boggess KA, O’Neil BH, et al. Delivery of a healthy baby after first-trimester maternal exposure to lapatinib. Clin Breast Cancer. 2006;7(4):339–41.PubMedGoogle Scholar
  36. 36.
    Braems G, Denys H, De Wever O, Cocquyt V, Van den Broecke R. Use of tamoxifen before and during pregnancy. Oncologist. 2011;16(11):1547–51.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Barnavon Y, Wallack M. Management of the pregnant patient with carcinoma of the breast. Surg Gynecol Obstet. 1990;171(4):347–52.PubMedGoogle Scholar
  38. 38.
    Nugent P, O’Connell T. Breast cancer and pregnancy. Arch Surg. 1985;120(11):1221–4.PubMedGoogle Scholar
  39. 39.
    Epstein RJ. Adjuvant breast cancer chemotherapy during late-trimester pregnancy: not quite a standard of care. BMC Cancer. 2007;7:92.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Garber JE. Long-term follow-up of children exposed in utero to antineoplastic agents. Semin Oncol. 1989;16(5):437–44.PubMedGoogle Scholar
  41. 41.
    Potter JF, Schoeneman M. Metastasis of maternal cancer to the placenta and fetus. Cancer. 1970;25(2):380–8.PubMedGoogle Scholar
  42. 42.
    Moran MS, Colasanto JM, Haffty BG, Wilson LD, Lund MW, Higgins SA. Effects of breast-conserving therapy on lactation after pregnancy. Cancer J. 2005;11(5):399–403.PubMedGoogle Scholar
  43. 43.
    Azim HA Jr, Bellettini G, Gelber S, Peccatori FA. Breast-feeding after breast cancer: if you wish, madam. Breast Cancer Res Treat. 2009;114(1):7–12.PubMedGoogle Scholar
  44. 44.
    Anderson RA, Rosendahl M, Kelsey TW, Cameron DA. Pretreatment anti-Müllerian hormone predicts for loss of ovarian function after chemotherapy for early breast cancer. Eur J Cancer. 2013;49(16):3404–11. Epub 2013 Aug 19.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Hoover HC Jr. Breast cancer during pregnancy and lactation. Surg Clin North Am. 1990;70:1151–63.PubMedGoogle Scholar
  46. 46.
    Vange NVD, Dongen JAV. Breast cancer and pregnancy. Eur J Surg Oncol. 1991;17:18.Google Scholar
  47. 47.
    Petrek JA, Dukoff R, Rogatko A. Prognosis of pregnancy associated breast cancer. Cancer. 1991;67(4):869–72.PubMedGoogle Scholar
  48. 48.
    Ribeiro G, Jones DA, Jones M. Carcinoma of the breast associated with pregnancy. Br J Surg. 1986;73(8):607–9.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maurício Magalhães Costa
    • 1
    • 2
    • 3
    • 4
    • 5
  • Paula Saldanha
    • 6
    • 1
  1. 1.Americas Centro de Oncologia IntegradaRio de JaneiroBrazil
  2. 2.National Academy of MedicineRio de JaneiroBrazil
  3. 3.President Senologic International SocietyStrasbourgFrance
  4. 4.International Gynecologic Cancer SocietyChicagoUSA
  5. 5.Americas Medical CityRio de JaneiroBrazil
  6. 6.Specialization in Clementino Fraga Filho University Hospital (UFRJ)Rio de JaneiroBrazil

Personalised recommendations