Treatment of pregnancy-associated breast cancer

Janni, Wolfgang; Hepp, Philip; Nestle-Kraemling, Carolin; Salmen, J; Rack, Brigitte; Genss, E. M.; Scheffold, Christian; Friese, Klaus

doi:10.1517/14656560903168906

Cited by 7 publications

(25 citation statements)

References 75 publications

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“…However, poorly differentiated, high T status, advancedstage, and metastatic breast cancers require much more complex medical treatments [1][2][3][4]. The determination of appropriate therapeutic strategies plays an important role in reducing the mortality of the disease [5].…”

Section: Introductionmentioning

confidence: 99%

High nuclear phosphorylated extracellular signal-regulated kinase expression associated with poor differentiation, larger tumor size, and an advanced stage of breast cancer

Kuo¹,

Hsu²,

Chang³

et al. 2013

pjp

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Extracellular signal-regulated kinase (ERK1/2) is implicated in the malignant behavior of breast cancer cells. However, previous clinical-pathological studies have shown that expression of activated/phosphorylated ERK1/2 is not associated with enhanced proliferation and invasion of mammary carcinomas. ERK1/2 is expressed in the cytoplasm, and activated/phosphorylated ERK1/2 translocates to the nucleus. The aim of this study is to evaluate nuclear phosphorylated ERK1/2 as a biomarker for breast cancer prognosis. The clinical-pathological relation of cytoplasmic/nuclear phosphorylated ERK1/2 was analyzed in 105 surgically resected breast cancer specimens by immunohistochemistry with tissue microarray. The results showed that non-neoplastic breast tissue mainly showed faint phosphorylated ERK1/2 staining. No statistically significant association was found between the level of cytoplasmic phosphorylated ERK1/2 expression and the clinical features of the disease. High nuclear phosphorylated ERK1/2 expression was associated with high grade (poor differentiation, p = 0.010), high T status (larger tumor size, p = 0.033), and an advanced stage (p = 0.018) of the disease. Thus, nuclear phosphorylated ERK1/2 is associated with enhanced proliferation and invasion of mammary carcinomas and may be a biomarker for breast cancer prognosis and the determination of therapeutic strategies.

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Section: Introductionmentioning

confidence: 99%

High nuclear phosphorylated extracellular signal-regulated kinase expression associated with poor differentiation, larger tumor size, and an advanced stage of breast cancer

Kuo¹,

Hsu²,

Chang³

et al. 2013

pjp

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“…Cyclophosphamide, adriamycine and fluorouracil combination is frequently used during pregnancy and is well tolerated. Anthracycline based chemotherapy can be used in pregnant women after the first trimester (62). Current evidence showed that taxanes do not pose any risk to the fetus beyond the first trimester (63).…”

Section: Systemic Chemotherapy In Pregnant Women With Breast Cancermentioning

confidence: 99%

“…Taxanes can also be appropriate for neoadjuvant chemotherapy before surgery or as a second line drug for anthracycline resistant cases. Alkylating agents and methotrexate are not used during pregnancy (62). HER2/neu is synthesized from many embryonic tissues during pregnancy.…”

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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“…For this reason, it is imperative that the pathologist be informed that the woman is pregnant or lactating. 10 After a diagnosis is made, the extent of disease is evaluated. As with non-pregnant patients with breast cancer, the TNM staging system of the American Joint Committee on Cancer is used to describe the extent of breast cancer in PABC.…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

“…There is unresolved controversy as to whether this is due to delay in diagnosis or whether the pregnancy-associated altered vascularity, increased serum hormone levels and immunosuppression result in acceleration of tumour dynamics. 10 Oestrogen receptors and progesterone receptors are frequently negative in PABC as shown in Table 1. The high circulating concentrations of steroids in pregnancy might interfere with the assays used in determining hormonal receptor status.…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

Pregnancy and breast cancer

Sasidharan

Harvey

2010

Obstet Med

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Breast cancer is one of the most commonly diagnosed malignancies during pregnancy. Pregnancy-associated breast cancer (PABC) presents a challenging clinical situation. This article reviews the current evidence around the management of PABC and the safety of pregnancy after breast cancer. The trend towards later age at first childbirth has resulted in an increase in the number of breast cancer cases coexistent with pregnancy. The management of breast cancer during pregnancy requires a multidisciplinary team approach. Breast surgery can be safely performed during any trimester of pregnancy. Radiation therapy, if required, must be delayed until after delivery. The majority of patients with PABC require chemotherapy. The timing of delivery in relation to chemotherapy administration should be carefully considered. There is no evidence to date that pregnancy termination influences overall survival for the mother. To date, there is no clear evidence that subsequent pregnancy after breast cancer is associated with worse maternal survival. There is a suggestion that subsequent pregnancy may in fact be associated with an improved survival. However, the available studies are limited by potential biases.

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Treatment of pregnancy-associated breast cancer

Abstract: This article summarizes the special features of the diagnosis and primary therapy of pregnancy-associated breast cancer with particular emphasis on cytotoxic therapy.

Cited by 7 publications

References 75 publications

High nuclear phosphorylated extracellular signal-regulated kinase expression associated with poor differentiation, larger tumor size, and an advanced stage of breast cancer

High nuclear phosphorylated extracellular signal-regulated kinase expression associated with poor differentiation, larger tumor size, and an advanced stage of breast cancer

Pregnancy associated breast cancer and pregnancy after breast cancer treatment

Pregnancy and breast cancer

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