Fulltext

Breast cancer and pregnancy

Knabben, Laura ; Mueller, Michel D.

In: Hormone Molecular Biology and Clinical Investigation, 2017, vol. 32, no. 1, p. -

Add to personal list
    Title
    • Breast cancer and pregnancy
    Author
    • Knabben, Laura. Department of Obstetrics and Gynaecology, University Hospital of Berne, Effingerstrasse 102, 3010 Berne, Switzerland, Phone: +41 31 632 10 10, Fax: +41 31 632 12 05
    • Mueller, Michel D.. Department of Obstetrics and Gynaecology, University Hospital of Berne and University of Berne, Berne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Hormone Molecular Biology and Clinical Investigation, 2017, vol. 32, p. 1. De Gruyter
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:331379
    Summary
    AbstractBackground 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.