Breast cancer during pregnancy: retrospective institutional case series
und | 04. Mai 2021
Über diesen Artikel
Article Category: Research Article
Online veröffentlicht: 04. Mai 2021
Seitenbereich: 362 - 368
Eingereicht: 29. Aug. 2020
Akzeptiert: 29. März 2021
DOI: https://doi.org/10.2478/raon-2021-0022
© 2021 Erika Matos, Tanja Ovcaricek, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Individual patients and tumours characteristics with details of treatment
| Patient | Patient’s age at BC diagnosis (years) | GA at BC diagnosis (weeks) | BC stage, tumor grade | HR HER2 BRCA | Systemic treatment during pregnancy | Mode of delivery | Complications at delivery, post-partum | Type of BC surgery | Post-partum treatment |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 34 | 28 | T2N1M0 IIB G3 | ER/PR neg HER2 poz BRCA pos | EC | Vaginal | - | MRM | Doce, trastuzumab RT |
| 2 | 28 | 13 | T2N0M0 IIA G3 | ER/PR neg HER2 neg BRCA neg | EC | CS | Placenta praevia, delivery at 27 weeks of gestation | BCS and ALND | EC, pacli RT |
| 3 | 37 | 32 | T2N0M0 IIA G3 | ER/PR neg HER2 neg BRCA neg | EC | Vaginal | - | BCS and SNB | EC, pacli RT |
| 4 | 38 | 40 | T3N1M0 IIIA G2 | ER/PR pos HER2 pos BRCA neg | - | Vaginal | - | MRM | FEC, doce, trastuzumab, tamoxifen, RT |
| 5 | 27 | 14 | T1N0M0 IA G3 | ER/PR neg HER2 neg BRCA pos | EC | Vaginal | - | Mastectomy and SNB and reconstruction (expander) | - |
| 6 | 34 | 8 | T2N0M0 IIA G3 | ER/PR pos HER2 pos BRCA ND | - | NR | Pregnancy termination advised, 10 weeks of gestation | MRM | FEC, doce, trastuzumab, tamoxifen, RT |
| 7 | 30 | 24 | T3N0M0 IIB G3 | ER/PR neg HER2 neg BRCA pos | AC, pacli | CS | - | Mastectomy and SNB and reconstruction (expander) | Cape, RT |
| 8 | 32 | 26 | T4dN2M1 IV G2 | ER/PR pos HER2 pos BRCA ND | AC | Vaginal | - | No surgery | Doce, trastuzumab, tamoxifen, RT |
| 9 | 39 | 13 | T2N1M0 IIB G2 | ER/PR pos HER2 neg BRCA ND | AC | Vaginal | - | MRM | Pacli, tamoxifen |
| 10 | 32 | 30 | T1cN0M0 IA G3 | ER/PR pos HER2 neg BRCA pos | - | CS | Induced delivery, 35 weeks of gestation | Mastectomy and SNB | EC, tamoxifen |
| 11 | 29 | 6 | T2N2M0 IIIA G3 | ER/PR neg HER2 pos BRCA neg | EC | Vaginal | - | MRM | Trastuzumab, RT |
| 12 | 33 | 6 | T1miN0M0 IA G3 | ER/PR neg HER2 neg BRCA neg | - | Unknown | - | Mastectomy and SNB | - |
| 13 | 31 | 38 | T3N2M0 IIIA G3 | ER/PR neg HER2 neg BRCA ND | - | Vaginal | - | MRM | FEC, doce, RT |
| 14 | 38 | 36 | T3N2M1 IV G3 | ER/PR pos HER2 pos BRCA neg | - | Vaginal | - | No surgery | Doce, pertuzumab, trastuzumab, tamoxifen |
Treatment of pregnant breast cancer patients
| Gestational age | Surgery | Systemic treatment | Treatment after delivery |
|---|---|---|---|
| 1st trimester | Mastectomy + SNB/ALND | Adjuvant ChT beginning in 2nd trimester | Adjuvant ET/anti-HER2 therapy (if indicated) + RT (if indicated) |
| 2nd and 3rd trimester | Mastectomy/BCS + SNB/ALND | ChT (adjuvant/neo-adjuvant) | Adjuvant ET/anti-HER2 therapy (if indicated) + RT (if indicated) |
| Late 3rd trimester | Mastectomy/BCS + SNB/ALND | Adjuvant ET/anti-HER2 therapy (if indicated) + RT (if indicated) |
Diagnostic procedures for pregnant breast cancer patients
| Diagnostic procedures | Patients selection |
|---|---|
| Breast US with CNB | All patients |
| Mammography | All patients |
| Chest X-ray | All patients |
| CNB: tumor grade, ER, PR, HER2 status | All patients |
| Laboratory test (CBC, ALP, LFT, CA 15-3) | All patients |
| Liver US | Liver metastases suspected |
| Bone MRI | Bone metastases suspected |