Children Exposed to Treatments in Utero in Pregnant Patients with Breast Cancer: Experience from Two Large Egyptian Hospitals

Abstract

Background: Pregnancy-associated breast cancer (PABC) is one of the common malignancies during pregnancy. Limited data is present about the effect of anticancer therapy on children born to mothers exposed to in utero treatments. Aim: To describe the outcome of pregnancy in a cohort of Egyptian patients treated for PABC. Methods: We reviewed all breast cancer cases diagnosed during pregnancy at two large Egyptian institutions between January 2009 and December 2016. Thirty-eight patients with complete obstetric and fetal data were included. Results: All patients received anthracycline-based chemotherapy in the 2 nd and 3 rd trimesters and 9 of them received paclitaxel. The mean gestational age at delivery was 35.7 ± 3.4 weeks. The mean birth weight was 2736 ± 768 grams. Congenital anomaly (cleft lip and tongue tie) was reported in only one (4%) child. Perinatal death occurred in one (4%) baby due to prematurity. One (4%) child was exposed to trastuzumab in utero in the 1 st trimester and he was completely healthy. Two (8%) other children were exposed to tamoxifen with no complications either neonatal or postnatal. Conclusion: Chemotherapy during pregnancy may be used with minimal maternal and fetal complications. Multidisciplinary approach is crucial for better management. Continued long-term follow-up of the children in this cohort is required.