Breast cancer during pregnancy: diagnosis, treatment, prognosis
Abstract
The breast cancer ranks first among all cancer types diagnosed during pregnancy or up to 1 year after delivery. Most notable practicing obstetricians should remember about possibility breast cancer during pregnancy and lactation. In case of suspicious lesion standard diagnostic algorithm for pregnant women should be fulfilled completely. The delay of diagnostic procedures until after delivery is unacceptable. The strategy of treatment is individual and should be worked out at a multidisciplinary consilium. The individual treatment planning is provided by breast unit team including oncosurgeon, clinic oncologist, radiation oncologist, anesthesiologist, obstetrician and certainly clinic psychologist. The optimal option is accumulation of pregnancy-associated breast cancer patients in a specialized oncologic clinic including obstetrics outpatient and inpatient units. A majority of studies report that survival is worse of pregnancy-associated breast cancer patients than of their non-pregnant counterparts.
About the Authors
M. D. Ter-Ovanesov
People’s Friendship University of Russia; Municipal Clinical Hospital No. 40
Russian Federation
Russian Federation
E. P. Shal
PSI Co
Russian Federation
Russian Federation
M. Yu. Kukosh
People’s Friendship University of Russia; Municipal Clinical Hospital No. 40
Russian Federation
Russian Federation
A. N. Oganisyan
People’s Friendship University of Russia
Russian Federation
Russian Federation
References
1. Дашян Г. А., Пароконная А. А., Семиглазова Т. Ю. Рак молочной железы и беременность. Клинические рекомендации Российского общества онкомаммологов, 2015. М., 13 с.
2. Пароконная А. А. Рак молочной железы и беременность (особенности клиники, диагностики и лечения, прогноз). Дис.. д-ра мед. наук.- Москва, 2009.
3. Состояние онкологической помощи населению России в 2017 году. Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М. МНИОИ им. П. А. Герцена, 2018.- 236 с.
4. Amant F, Vandenbrouche T, Verheecke M, et al. International Network on Cancer, Infertility, and Pregnancy (IINCIP). Pediatric Outcome after Maternal Cancer Diagnosed during pregnancy. N. Engl. J. Med. 2015; 373 (19): 1824-34.
5. Azim Jr HA, Santoro L, Russell-Edu W, et al. Prognosis of pregnancy-associated breast cancer: a meta-analyses of 30 studies. Cancer Treat Rev. 2012; 38 (7): 834-842.
6. Azim Jr HA, Botterl E, Renne G, et al. The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study. Acta Oncol. 2012; 51: 653-61.
7. Azim HA Jr, Brohée S, Peccatorl FA, et al. Biology of breast cancer during pregnan -cy using genomic profiling. Endocr Relat Cancer. 2014 Aug; 21 (4): 545-54. doi: 10.1530/ERC-14-0111. Epub 2014, May 13.
8. Aziz S, Pervez S, Khan S, et al. Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma. Pathol Res Pract. 2003; 199 (1): 15-21.
9. Bonnier P, Romain S, Dilhuydy JM, et al. Influence of pregnancy on the outcome of breast cancer: a case-control study. Societe Francaise de Senologie et de Pathologie Mammaire Study Group. Int J Cancer. 1997; 72 (5): 720-7.
10. Brent RL. Carcinogenic risks of prenatal ionizing radiation. Seminars in Fetal and Neonatal Medicine. 2014; 19: 203-213.
11. Chen Z, King W, Pearcey R, et al. The relationship between waiting time for radiotherapy and outcome: a systematic review of the literature. Radiother Oncol. 2008; 87: 3-16.
12. Collettl PM, Lee KH, Elkayam U. Cardiovascular imaging of the pregnant patient. AJR AmJ Roentgenol. 2013; 200 (3): 515-521.
13. Couch FJ, Hart SN, Sharma P, et al. Inherited mutations in 17 breast cancer susceptibility genes among a large triple-negative breast cancer cohort unselected for family history of breast cancer. J Clin Oncol. 2015; 33: 304-11.
14. Dieci, M.V., Orvieto, E., Dominici, M., et al. Rare breast cancer subtypes: histological, molecular, and clinical peculiarities. Oncologist. 2014; 19: 805-13.
15. Framarino-Dei-Malatesta M., Sammartino P., Napoll A. Does anthracycline-based chemotherapy in pregnant women with cancer offer safe cardiac and neurodevelopmental outcomes for the developing fetus? BMC Cancer. 2017; 17: Р. 777.
16. Golubnitschaja O, Debald M, Yeghiazaryan K, et al. Breast cancer epidemic in the early twenty-first century: evaluation of risk factors, cumulative questionnaires and recommendations for preventive measures. Tumour Biol. 2016; 37 (10): 12941-57.
17. Hahn, K.M., Johnson, P.H., Gordon, N., et al., Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer. 2006; 107: 1219-26.
18. Han SN, Amant F, Sangalll C, et al. sentinel lymph node biopsy for breast cancer treatment pregnancy- on behalf of the lnternational Network of cancer, lnfertility and pregnancy (lNClP) and the German Breast Group (GBG). Ann. Oncol. 2014; 25 (Suppl4): P. 266 PD.
19. Jones AL. Management of pregnancy-associated breast cancer. Breast. 2008; 17: 213.
20. Kim YG, Jeon YW, Ko BK, et al. Clinicopathologic characteristics of pregnancy-associated breast cancer: results of analysis of a nationwide breast cancer registry database. J Breast Cancer. 2017; 20 (3): 264-9.
21. Kotsopoulos J, Lubinskl J, Salmena L, et al., Hereditary Breast Cancer Clinical Study Group: Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res. 2012; 14: R42.
22. Langer A, Mohallem M, Stevens D, et al. A single-institution study of 117 pregnancy-associated breast cancers (PABC): presentation, imaging, clinicopathological data and outcome. Diagn lnterv lmaging. 2014; 95 (4): 435-41.
23. Litton JK, Warneke CL, Hahn KM, et al. Case control study of women treated with chemotherapy for breast cancer during pregnancy as compared with nonpregnant patients with breast cancer. Oncologist. 2013; 18 (4): 369-76.
24. Loibl S., Sileny N Han, Gunter von Minckwitz, et al., Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol. 2012; 13: 887-96.
25. Madaras L, Kovacs KA, Szasz AM, et al. Clinicopathological features and prognosis of pregnancy associated breast cancer - a matched case-control study. Pathol. Oncol. Res. 2014; 20 (3): 581-590.
26. Managing cancer during pregnancy/ Ed. Azim Jr HA. Springer, 2016. P. 191.
27. Martinez M. T., Bermejo B., Hernando C., et al. Breast cancer in pregnant patients: a review of the literature. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2018.
28. Mathews TJ, Hamilton BE. First births to older women continue to rise. National Center for Health Statistics, Hyattsville, MD. NCHS Data Brief No. 152. 2014: 1-8.
29. McCollough, Schueler BA, Atwell TD, et al. Radiation exposure and pregnancy: when should we be concerned? Radiographics. 2007; 27 (4): P. 917-918.
30. Moebus V, Jackisch C, Lueck HJ, et al. lntense-dose sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high risk primary breast cancer: mature results of an AGO phase lll study. J. Clin. Oncol. 2010; 28 (17): 2874-80.
31. National Toxicology Program. NTP monograph: developmental effects and pregnancy outcomes associated with cancer chemotherapy use during pregnancy. NTP Monogr. 2013; (2): 1-214.
32. Paluch-Shimon S, Paganl O, Partridge AH, et al. Second international consensus guidelines for breast cancer in young women (BCY2). Breast. 2016; 26: 87-99.
33. Polivka J. Jr., lrem Altun, Olga Golubnitschaja, Pregnancy-associated breast cancer: the risky status quo and new concepts of predictive medicine, EPMA J. 2018 Feb 8; 9 (1): 1-13.
34. Rimawl BH, Green V, Lindsay M. Fetal lmplications of Diagnostic Radiation Exposure During Pregnancy: Evidence-based Recommendations. Clin Obstet Gynecol. 2016; 59: 412-8.
35. Rodriguez AO, Chew H, Cress R, et al. Evidence of poorer survival in pregnancy-as -sociated breast cancer. Obstet Gynecol. 2008; 112 (1): 71-8.
36. Rosenberg SM, Ruddy KJ, Tamiml RM, et al. BRCA1 and BRCA2 mutation testing in young women with breast cancer. JAMA Oncol. 2016; 2: 730-6.
37. Sanchez C, Acevedo F, Medina L, et al. Breast cancer and pregnancy: a comparative analysis of a Chilean cohort. E-cancer medica science. 2014; 8: 434.
38. Shachar SS, Gallagher K, McGuire K, et al. Multidisciplinary Management of Breast Cancer During Pregnancy. Oncologist. 2017 Mar; 22 (3): 324-334.
39. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017; 67: 7-30.
40. Stuebe AM, Willett WC, Xue F, et al. Lactation and incidence of premenopausal breast cancer: a longitudinal study. Arch lntern Med. 2009; 169 (15): 1364-1571.
41. Toesca A, Gentilinl O, Peccatorl F, et al., Locoregional treatment of breast cancer during pregnancy. Gynecol Surg. 2014; 11: 279-84.
42. van Hasselt JG, van Calsteren K, Heyns L, et al. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetics analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel. Ann Obcol. 2014; 25 (10): 2059-65.
43. Yang WT, Dryden MJ, Gwyn K, et al. lmaging of breast cancer diagnosed and treated with chemotherapy during pregnancy. Radiology. 2006; 239: 52-60.
44. Zagourl F, Psaltopoulou T, Dimitrakakis C, et al. Challenges in managing breast cancer during pregnancy. J. Thorac. Dis. 2013; 5. Suppl. 1. S. 62-7.
45. Zanotti-Fregonara P, Laforest R, Wallis JW. Fetal Radiation Dose from 18F-FDG in Pregnant Patients lmaged with PET, PET/CT, and PET/MR. J Nucl Med. 2015 Aug; 56 (8): 1218-22. doi: 10.2967/jnumed.115.157032. Epub 2015 Jun 18.
46. Zanotti-Fregonara P, Chastan M, Edet-Sanson A, et al., New Fetal Dose Estimates from 18F-FDG Administered During Pregnancy: Standardization of Dose Calculations and Estimations with Voxel-Based Anthropomorphic Phantoms. J Nucl Med. 2016 Nov; 57 (11): 1760-1763. Epub 2016 Jun 3.
Review
For citations:
Ter-Ovanesov M.D., Shal E.P., Kukosh M.Yu., Oganisyan A.N. Breast cancer during pregnancy: diagnosis, treatment, prognosis. Medical alphabet. 2018;2(29):10-16. (In Russ.)
Views:
326
Email this article 