Breast and cervix cancers are the most common malignancies in reproductive-age women. Based on the epidemiological data 12-30 new pregnancy associated breast cancer (PABC) cases are in Hungary yearly. A pregnant woman with a gynaecologic malignancy presents a significant challenge for the clinician for many reasons. Considerable diagnostic delay is common due to confusion of symptomatology with the physiologic changes associated with the pregnant state. The diagnostic options available for a patient suspected of having breast cancer may also be compromised by the pregnancy. In addition, difficult treatment of these malignancies may incompatible with continuation of the pregnancy. In the previous data no increased risk of death from breast cancer has been demonstrated in women who are pregnant when diagnosed or later become pregnant. Though young age, more progressed cancer at the time of diagnosis, high rate of estrogene receptor negativity as well as the potentially orphan foetus make the PABC even graver. In the National Cancer Institute, Hungary we treated 12 PABC patient in the last 11 years. Most of them were in an advanced stage at the time of diagnosis. 6 first trimester pregnancies were terminated, because of emotional and medical reasons, not to impede later cancer treatment. Treatment of choice is surgery, sector excision with sentinel or axial lymph node dissection, and modified radical mastectomy with axial lymph node dissection in advanced stages. Operations were done in the second and early third trimesters without any delay. Adjuvant chemotherapy is relatively safe in the late second and early third trimesters until the 31-32 gestational weeks, i.e. 3 weeks prior the planed termination of pregnancy. Chemotherapy can be postponed after induced delivery on the 34-35 weeks. We postpone the adjuvant irradiation after delivery, to avoid foetal damage. There were 6 live birth of the 12 PABC. Manual, ultrasound or NMR examinations done before the planned pregnancy or in the first trimester enhance early breast cancer detection over 35 years.
|Translated title of the contribution||Treatment and consequences of pregnancy associated breast cancer on mother and foetus|
|Number of pages||10|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - Oct 22 2004|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology