Breastfeeding After Breast Cancer: Feasibility, Safety, and Ethical Perspectives

Linkeviciute, Alma; Notarangelo, Micaela; Buonomo, Barbara; Bellettini, Giulia; Peccatori, Fedro Alessandro

doi:10.1177/0890334419887723

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…It was evident in the included guidelines that patient counselling and decisional support is widely recognized as a standard of care for pregnant cancer patients [ 22 , 24 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 40 , 41 , 45 ]. Moreover, the patient is not left alone to make difficult moral choices and the most recent guidelines seem to support the maternalistic approach from the clinical teams by emphasizing the importance of available scientific evidence in patient counselling [ 14 ]. The content in clinical practice guidelines appears to support the ideas expressed elsewhere that clinicians cannot determine how the patients should view their disease, but when equipped with empathy and compassion clinicians can support their patients by explaining the logical rationale behind evidence-based clinical advice [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…This, however, depends on the gestational age of the fetus at the time of treatment, tumor type and disease stage, as treatments may induce developmental teratogenicity [ 10 , 11 , 12 ]. There are a number of ethical questions involved, especially when oncological prognosis is dire and a patient’s desire for parenthood is strong; practical questions such as breastfeeding after breast cancer are also frequently triggered in this setting [ 13 , 14 ]. Nevertheless, knowledge regarding bioethical aspects arising during this unusual co-occurrence is scarce [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Guidelines for Cancer Treatment during Pregnancy: Ethics-Related Content Evolution and Implications for Clinicians

Linkeviciute

Canário

Peccatori

et al. 2022

Cancers

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(1) Background: Current scientific evidence suggests that most cancers, including breast cancer, can be treated during pregnancy without compromising maternal and fetal outcomes. This, however, raises questions regarding the ethical implications of clinical care. (2) Methods: Using a systematic literature search, 32 clinical practice guidelines for cancer treatment during pregnancy published between 2002 and 2021 were selected for analysis and 25 of them mentioned or made references to medical ethics when offering clinical management guidance for clinicians. (3) Results: Four bioethical themes were identified: respect for patient’s autonomy, balanced approach to maternal and fetal beneficence, protection of the vulnerable and justice in resource allocation. Most guidelines recommended informing the pregnant patient about available evidence-based treatment options, offering counselling and support in the process of decision making. The relational aspect of a pregnant patient’s autonomy was also recognized and endorsed in a significant number of available guidelines. (4) Conclusions: Recognition and support of a patient’s autonomy and its relational aspects should remain an integral part of future clinical practice guidelines. Nevertheless, a more structured approach is needed when addressing existing and potential ethical issues in clinical practice guidelines for cancer treatment during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Guidelines for Cancer Treatment during Pregnancy: Ethics-Related Content Evolution and Implications for Clinicians

Linkeviciute

Canário

Peccatori

et al. 2022

Cancers

Self Cite

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“…Женщин, ранее получавших лечение по поводу РМЖ, у которых нет признаков рецидива, следует мотивировать к естественному вскармливанию детей. Важно информировать пациентов, что кормления только одной грудью часто бывает достаточно для адекватного роста и развития ребенка и не является поводом для отказа от ГВ [33].…”

Section: поддержка гв после перенесенного зноunclassified

Benefits and limitations of breastfeeding for mothers with malignant tumors

Ladodo,

Iurova,

Khokhlova

et al. 2024

J. Mod. Onco.

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In the modern world breastfeeding (BF) is considered as a significant factor in reducing the risk of developing malignant tumors of the mammary gland and ovaries. However, the problem of maintenance or refusing BF in malignant neoplasms (malignant neoplasms) still remains open. In recent years, there has been a steady increase in breast cancer (BC), especially in developed countries, with more than 10% of all breast malignancies (BC) diagnosed in women under 40 years of age. The presented article highlights aspects of maintaining lactation in different periods of the relevance of BF in relation to the timing of manifestation of cancer, and also presents data from the multicenter study POSITIVE (Pregnancy Outcome and Safety of Interrupting Therapy for women with endocrine responsIVE breast cancer) on the possibilities of implementing reproductive function and BF in women receiving therapy for hormone-receptor positive (HR+) BC stages I–III. BF with cancer detected in the postpartum period depends on the treatment of the underlying disease. In patients undergoing surgical treatment, BF is not contraindicated, but it is not always technically possible. During chemotherapy, BF is not recommended. When carrying out radiotherapy, it is possible to undergo BF using a healthy mammary gland. There is currently no evidence to suggest that BF woman diagnosed with cancer may have any negative effects. In general, it has been shown that preserving and maintaining lactation in women with a history of cancer is safe for both mother and child.

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“…Providing care to pregnant cancer patients is complex as they present healthcare needs and decisional dilemmas that encompass distinct and often overlapping dimensions [1]. Looking after these patients raises not only clinical challenges, such as choosing the most suitable treatment regiment, time of delivery and breastfeeding support following the birth of an infant, but also many concerns and decisional challenges for the patients [2] and ethical challenges for the clinical teams [3].…”

Section: Introductionmentioning

confidence: 99%

Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care

Linkeviciute,

Canario,

Peccatori

et al. 2024

Cancers

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(1) Background: Caring for pregnant cancer patients is clinically and ethically complex. There is no structured ethical guidance for healthcare professionals caring for these patients. (2) Objective: This concept paper proposes a theoretically grounded framework to support ethical and patient-centred care of pregnant cancer patients. (3) Methodological approach: The framework development was based on ethical models applicable to cancer care during pregnancy—namely principle-based approaches (biomedical ethics principles developed by Beauchamp and Childress and the European principles in bioethics and biolaw) and relational, patient-focused approaches (relational ethics, ethics of care and medical maternalism)—and informed by a systematic review of clinical practice guidelines. (4) Results: Five foundational discussion themes, summarising the key ethical considerations that should be taken into account by healthcare professionals while discussing treatment and care options with these patients, were identified. This was further developed into a comprehensive ethics checklist that can be used during clinical appointments and highlights the need for a holistic view to patient treatment, care and counselling while providing ethical, patient-centric care. (5) Conclusion: The proposed framework was further operationalised into an ethics checklist for healthcare professionals that aims to help them anticipate and address ethical concerns that may arise when attending to pregnant cancer patients. Further studies exploring clinicians’ attitudes towards cancer treatment in the course of pregnancy and patient experiences when diagnosed with cancer while pregnant and wider stakeholder engagement are needed to inform the development of further ethical, patient-centred guidance.

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Breastfeeding After Breast Cancer: Feasibility, Safety, and Ethical Perspectives

Cited by 6 publications

References 17 publications

Guidelines for Cancer Treatment during Pregnancy: Ethics-Related Content Evolution and Implications for Clinicians

Guidelines for Cancer Treatment during Pregnancy: Ethics-Related Content Evolution and Implications for Clinicians

Benefits and limitations of breastfeeding for mothers with malignant tumors

Caring for Pregnant Patients with Cancer: A Framework for Ethical and Patient-Centred Care

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