Pregnancy associated breast cancer

Breast carcinoma during pregnancy put the health of the mother in conflict with that of the foetus. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risk of harm of the foetus. We report the epidemiology, pathology, clinical picture, therapeutic management and foetal outcome of pregnant women with breast cancer treated in our institution.

Twenty-two pregnant breast cancer patients were treated in our hospital from January 1996 to October 2006. Parents were surveyed by mail or telephone regarding outcomes of children exposed to chemotherapy in uterus.

The treatment of breast cancer pregnancy should conform as closely as possible to standardised protocols for patients without concomitant pregnancy. Most of the patients underwent surgery during pregnancy In four cases diagnosed during the first trimester chemotherapy was initiated during the 10th week when organogenesis period was finished. None of the children exposed to chemotherapy during this trimester presented congenital malformations. All 11 cases diagnosed during second and third trimester were treated with Doxorrubicin, Fluoracil and Cyclophosphamide and four cases were treated with taxanes. No congenital malformations were detected.

Breast cancer can be treated with FAC chemotherapy during the second and third trimesters without significant complications for the children exposed to chemotherapy in uterus. We report four cases treated with taxanes after the first trimester and no congenital anomalies were observed.