Breast cancer and pregnancy

Abstract

Background In the past decades the incidence of pregnancy-associated breast cancer (PABC) increased. Possible explanations are the trend to postpone childbearing and the general increase in the incidence of breast cancer. Materials and methods A sytematic review of the literature was performed with the aim to report on incidence, diagnosis, treatment and prognosis of breast cancer during pregnancy. We also cover the issue of pregnancy following a diagnosis of breast cancer including fertility preservation and prognosis. Results Ultrasound is the imaging method of choice in pregnancy, but mammography can also be performed as the fetal irradiation dose is low. To avoid a delay in diagnosis every sonographic mass in pregnant women which does not clearly correspond to a cyst needs further investigation by biopsy. Treatment should follow as close as possible the guidelines for non-pregnant patients. Administration of chemotherapy is possible after the first trimester. There is a large body of evidence for the use of anthracyclines. In contrast radiotherapy, trastuzumab and antihormonal treatment by tamoxifen are contraindicated during pregnancy. Pregnancy does not seem to influence prognosis. Most adverse obstetric outcomes are related to preterm delivery, which should therefore, whenever possible, be avoided. Young patients with breast cancer and incomplete family planning should be referred for counseling about fertility preservation options before the initiation of adjuvant treatment. A pregnancy following breast cancer does not have a negative impact on prognosis. Conclusion Multidisciplinary management of women with breast cancer in pregnancy is mandatory and data should be collected to allow further improvement in management.

Clinical, histological and radiological findings of invasive ductal carcinoma in a pregnant woman

“…3,4 Treatment should be as similar as possible to that offered to non-pregnant women. 8 Surgical treatment is considered safe to be performed at any trimester of pregnancy, with mastectomy being the surgery of choice. 8,9 Whether to perform or not a sentinel lymph node biopsy during the procedure remains without consensus in the literature.…”

“…8 Surgical treatment is considered safe to be performed at any trimester of pregnancy, with mastectomy being the surgery of choice. 8,9 Whether to perform or not a sentinel lymph node biopsy during the procedure remains without consensus in the literature. 8 Chemotherapy can also be performed after the first trimester of pregnancy, taking care to avoid certain chemotherapeutic drugs such as methotrexate.…”

“…8,9 Whether to perform or not a sentinel lymph node biopsy during the procedure remains without consensus in the literature. 8 Chemotherapy can also be performed after the first trimester of pregnancy, taking care to avoid certain chemotherapeutic drugs such as methotrexate. 9 Radiotherapy, hormone therapy and use of monoclonal antibodies are contraindicated during pregnancy.…”

“…9 Radiotherapy, hormone therapy and use of monoclonal antibodies are contraindicated during pregnancy. 8,9…”

Gravidez após o Cancro da Mama: Estado da Arte

“…Na verdade, o prognóstico das doentes que engravidam após o cancro da mama não parece ser agravado, 57 admitindo-se que mulheres que se sentem mais saudáveis, com estadios precoces da sua neoplasia têm maior probabilidade de engravidar e ter uma gravidez de termo, sem prejuí-zo de os pressupostos imunológicos e endócrinos poderem explicar este não agravamento do prognóstico.…”