Ambiguous genitalia in infant exposed to tamoxifen in utero

Tewari, Κ. Κ.; Bonebrake, Robert; Asrat, Tamerou; Shanberg, Allan M.

doi:10.1016/s0140-6736(97)24029-8

Cited by 124 publications

(47 citation statements)

References 4 publications

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“…Watson describes a case of reversible anhydramnios, while two other case reports report no immediate fetal or neonatal complications [74][75][76]. Tamoxifen therapy during pregnancy has been associated with ambiguous genitalia and Goldenhar's syndrome while other authors note no fetal/neonatal complication [77][78][79][80][81][82]. Tamoxifen is not recommended during gestation [4].…”

Section: Systemic Therapymentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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Breast cancer, along with cervical cancer, is one of the most commonly diagnosed cancers of pregnancy. Most would define gestational breast cancer as breast cancer that is diagnosed during pregnancy, lactation, and up to 12 months post-partum. The diagnostic and therapeutic implications in this clinical setting are special. These women typically present with a more advanced-stage disease that carries an associated poorer prognosis. Physicians thus are challenged to balance aggressive maternal care with appropriate modifications that will ensure fetal protection. . Of women diagnosed with breast cancer younger than 40 years, only approximately 10% will be pregnant [2,3]. These data certainly suggest a low incidence of pregnancy-associated breast cancer. In fact, historically, the incidence is estimated at 1 in 3000 pregnancies [4][5][6]. Despite the overall low incidence, however, gestational breast cancer is one of the most common pregnancy-associated malignancies, second only to cervical cancer [4,6]. Notably, many have offered that this incidence will only increase as more women delay childbearing until later in life [4,7]. This concern is based on the fact that pregnancy-associated breast cancer is age-related, and women

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Section: Systemic Therapymentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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“…During pregnancy Tamoxifen and its metabolites affects the rapidly growing fetal tissue. It leads to birth defects in 20% of exposures [2][3][4][5][6][7][8][9]. Astra Zeneca data base records of patients exposed to Tamoxifen during pregnancy, showed 16 live births with congenital abnormalities and 122 live births without malformations.…”

Section: Discussionmentioning

confidence: 99%

“…They became pregnant while on Tamoxifen, with no fetal abnormalities observed after deliveries [11]. A case reported by Tewari et.al described a case of an infant borne with ambiguous genitalia, and three other case reports described four live births with congenital anomalies, no specific abnormality is identified to be associated with exposure to Tamoxifen during pregnancy [4]. The relatively high frequency of congenital abnormalities means that reliable birth control during Tamoxifen treatment is essential during its use and a washout period of two months should be observed based on the known half-life of Tamoxifen.…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Case Using Tamoxifen during Pregnancy: A Case Report and Literature Review

Mohamed¹,

Mirghani²

2017

SJMS

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This is a case of 32 years old nulliparous female who was diagnosed in November 2004 as a case of carcinoma of the right breast , luminal A , (Estrogen Receptor positive Progesterone receptor negative, Her 2 negative, Ki67 10 %), poorly differentiated invasive ductal cancer, TNM stage,T2 N0 MO. She had a wide local excision and axillary clearance. As she is a case of low risk early stage luminal A breast cancer; she was not given chemotherapy, instead she had a course of external irradiation and was put on Tamoxifen (Astra Zeneca, 20 mg daily), and was advised not to get pregnant during this treatment, but she got pregnant and delivered normally a healthy infant, although Tamoxifen is potentially teratogenic.

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“…In the presence of limited data anti-HER2 therapies are not recommended during pregnancy and if there is medical necessity for their use, a close follow up of the amniotic fluid is mandatory. Selective estrogen receptor modulator tamoxiphene used in cases of hormone receptor positive breast cancers is teratogenic and may cause craniofacial malformations and ambiguous genitalia (66). Aromatase inhibitors were reported to be teratogenic in animals but there is insufficient data in humans (67).…”

Section: Systemic Chemotherapy In Pregnant Women With Breast Cancermentioning

confidence: 99%

Pregnancy associated breast cancer and pregnancy after breast cancer treatment

Döğer¹,

Çalışkan²,

Mallmann³

2011

J Turkish German Gynecol Assoc

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Breast cancer is one of the most common cancers diagnosed during pregnancy and its frequency is increasing as more women postpone their pregnancies to their thirties and forties. Breast cancer diagnosis during pregnancy and lactation is difficult and complex both for the patient and doctors. Delay in diagnosis is frequent and treatment modalities are difficult to accept for the pregnant women. The common treatment approach is surgery after diagnosis, chemotherapy after the first trimester and radiotherapy after delivery. Even though early stage breast cancers have similar prognosis, advanced stage breast cancers diagnosed during pregnancy and lactation have poorer prognosis than similar stage breast cancers diagnosed in non-pregnant women. Women who desire to become pregnant after treatment of breast cancer will have many conflicts. Although the most common concern is recurrence of breast cancer due to pregnancy, the studies conducted showed that pregnancy has no negative effect on breast cancer prognosis. In this review we search for the frequency of breast cancer during pregnancy, the histopathological findings, risk factor, diagnostic and treatment modalities. We reviewed the literature for evidence based findings to help consult the patients on the outcome of breast cancer diagnosed during pregnancy and lactation, and also inform the patients who desire to become pregnant after breast cancer according to current evidences. (J Turkish-German Gynecol Assoc 2011; 12: 247-55)

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Ambiguous genitalia in infant exposed to tamoxifen in utero

Cited by 124 publications

References 4 publications

Pregnancy-Associated Breast Cancer: A Literature Review

Pregnancy-Associated Breast Cancer: A Literature Review

Breast Cancer Case Using Tamoxifen during Pregnancy: A Case Report and Literature Review

Pregnancy associated breast cancer and pregnancy after breast cancer treatment

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