1
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Iyer P, Radhakrishnan V, Krishnamurthy A, Dhanushkodi M, V. S, Ananthi B, Selvaluxmy G. Real-World Experience of Treating Young Adult Patients with Breast Cancer from a Single Center in Southern India. South Asian J Cancer 2022; 11:105-111. [DOI: 10.1055/s-0041-1735481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background Breast cancer in young adults is rare and accounts for 5 to 6% of all cancers in this age group. We conducted the present study to look at the demographic features, clinical presentation, and outcomes in this group of patients treated at our center.
Patients and Methods The study included breast cancer patients between the age of 15 and 30 years treated at our institute from January 2009 to December 2016. Data were analyzed retrospectively from case records. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan–Meier method.
Results Young adult breast cancers were reported in 145 out of 6,000 patients (2.41%) diagnosed with breast cancer in the study period. The median age of the patients was 29 years (range: 21–30 years). Stage I, II, III, and IV was observed in 3.4, 33.7, 46.2, and 16.5% of patients, respectively. The median follow-up was 45 months (range: 1.7–128.1 months). The 5-year EFS and OS for stage I, II, III, and IV was 100, 74.5, 47.9, and 0% and 100, 90.8, 55.1, and 0%, respectively. On univariate analysis, stage of the disease and pregnancy-associated breast cancers were found to have a significant association with decreased EFS and OS (p < 0.001, p = 0.008 and p < 0.001, p = 0.001, respectively). On multivariate analysis, stage of disease and pregnancy-associated breast cancers remained significant predictors of EFS and OS.
Conclusion Breast cancers in young adults are rare but need to be diagnosed at an early stage to improve survival. Pregnancy-associated breast cancers need to be managed optimally without delay owing to their aggressive tumor biology.
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Affiliation(s)
- Priya Iyer
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Venkatraman Radhakrishnan
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Arvind Krishnamurthy
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Manikandan Dhanushkodi
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Sridevi V.
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Balasubramanian Ananthi
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
| | - Ganeshraja Selvaluxmy
- Departments of Radiation Oncology, Medical Oncology and Surgical Oncology, Cancer Institute (WIA, Chennai, Tamil Nadu, India
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2
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Rosas CHDS, Góes ACDA, Saltão LM, Tanaka AMDS, Marques EF, Bitencourt AGV. Pregnancy-lactation cycle: how to use imaging methods for breast evaluation. Radiol Bras 2020; 53:405-412. [PMID: 33304009 PMCID: PMC7720671 DOI: 10.1590/0100-3984.2019.0071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pregnancy and lactation constitute states of intense hormonal variation with secretory and structural changes in the breast parenchyma. These changes translate into important features on breast imaging, as well as the emergence of specific benign and malignant lesions. This literature review aims to discuss the safety of the use of breast imaging methods (mammography, ultrasound, and magnetic resonance imaging) during the pregnancy-lactation cycle, and to present the expected physiological changes and imaging appearance of the main breast diseases that may occur in this period, such as galactocele, lactating adenoma, fibroadenoma, puerperal mastitis, and pregnancy-associated breast cancer.
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3
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Multidisciplinary consensus on cancer management during pregnancy. Clin Transl Oncol 2020; 23:1054-1066. [PMID: 33191439 PMCID: PMC8084770 DOI: 10.1007/s12094-020-02491-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022]
Abstract
Cancer during pregnancy is a challenge for multi- and interdisciplinary collaboration due to the diagnostic, prognostic and therapeutic implications, the need for an integrated harmonization of medical action for the pregnant patient and the embryo or foetus and the characteristics of each gestational period, which will determine the protocol to be proposed and its limitations. For this reason, a group of experts appointed by participating scientific societies, which includes the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica—SEOM), the Spanish Association of Surgeons (Asociación Española de Cirujanos—AEC), the Spanish Society of Gynaecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia—SEGO), the Spanish Society of Nuclear Medicine and Molecular Imaging (Sociedad Española de Medicina Nuclear e Imagen Molecular—SEMNIM), the Spanish Society of Oncological Radiotherapy (Sociedad Española de Oncología Radioterápica—SEOR) and the Spanish Society of Medical Radiology (Sociedad Española de Radiología Médica—SERAM), have worked together to establish consensus recommendations that allow the harmonization of management and ultimately the optimization of the healthcare of pregnant patients with cancer. When cancer is detected in a pregnant woman, the week of gestation in which the diagnosis is made must be considered, as well as the characteristics of the tumour. It is strongly recommended that a multidisciplinary team assesses the situation and guides the patient and her family during the informing, diagnosis and treatment process. Likewise, the foetus should be monitored and managed by specialized obstetricians who are part of a multidisciplinary cancer committee.
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4
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Schad A, Slostad J, Rao R. Gestational breast cancer: current challenges in staging and treatment of breast cancer. BMJ Case Rep 2020; 13:e235308. [PMID: 33148569 PMCID: PMC7640451 DOI: 10.1136/bcr-2020-235308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/03/2022] Open
Abstract
Gestational breast cancer (GBC) is the most common form of invasive cancer in pregnancy and has unique challenges in both staging and treatment given the dual goal of appropriate cancer management and minimising the risk of fetal toxicity. A 38-year-old woman with no significant medical history and 21 weeks pregnant presented with a palpable right breast mass. She was diagnosed with human epidermal growth factor receptor 2-positive infiltrating ductal carcinoma with advanced disease. The patient underwent treatment; however, unfortunately, she passed away after developing devastating distant disease recurrence.We highlight both the challenges and current guidelines for management of GBC. Our goal is to discuss the current limitations of GBC management and the necessity of further investigation for safe novel imaging and treatment modalities for pregnant women. It is crucial to increase awareness across multiple subspecialities, as a multidisciplinary team is necessary for proper treatment of GBC.
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Affiliation(s)
- Aimee Schad
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Jessica Slostad
- Division of Hematology, Oncology, and Stem Cell Transplant, Rush University Medical Center, Chicago, IL, United States
| | - Ruta Rao
- Division of Hematology, Oncology, and Stem Cell Transplant, Rush University Medical Center, Chicago, IL, United States
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5
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Del Gobbo A, Scarfone G, Peccatori FA, Villa A, Ossola W, Ercoli G, Bosari S, Ferrero S, Boggio FL, Grossi E, Cribiù FM. Chemotherapy for breast cancer during pregnancy induces vascular alterations and impaired development of placental villi: A preliminary histopathological study. Eur J Obstet Gynecol Reprod Biol 2020; 250:155-161. [PMID: 32442841 DOI: 10.1016/j.ejogrb.2020.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/24/2020] [Accepted: 04/01/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate histological alterations in placentas of women affected by breast cancer and treated with chemotherapy during pregnancy. STUDY DESIGN We retrospectively reviewed histological slides of 23 placentas of patients affected by breast cancer and treated with chemotherapy during pregnancy and 23 control placentas of women without breast cancer and with physiological pregnancies of the same gestational age. RESULTS All the patients had breast ductal infiltrating carcinoma, 19 of 23 cases had a G3 cancer. All patients were treated with 2-6 cycles of chemotherapy starting after 16 weeks of gestation, with different protocols. No hypertensive complications and no pre-eclampsia episodes were observed; birth weight was consistent with gestational age in all babies in both group with no uneventful outcomes and no perinatal mortality or fetal malformations. Twenty out of 23 cases (86 %) showed hypoxia-induced villous alterations, including increased syncytial knotting (Tenney-Parker changes), perivillar fibrin deposits, distal villous hypoplasia or accelerated maturation and focal villous chorangiosis. These alterations were found in 19 out of 23 controls (83 %), with no statistically significant difference between the two groups. CONCLUSIONS These results shows that chemotherapy in the second and third trimester of pregnancy may lead to non-specific alterations in placental vasculature and morphology.
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Affiliation(s)
- Alessandro Del Gobbo
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giovanna Scarfone
- Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Fedro Alessandro Peccatori
- Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Antonella Villa
- Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Wally Ossola
- Department of Obstetrics, Gynecology and Neonatology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Ercoli
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvano Bosari
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Francesca Laura Boggio
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Grossi
- Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology IRCCS, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Fulvia Milena Cribiù
- Division of Pathology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
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6
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Breast milk paclitaxel excretion following intravenous chemotherapy-a case report. Br J Cancer 2019; 121:421-424. [PMID: 31363168 PMCID: PMC6738114 DOI: 10.1038/s41416-019-0529-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/13/2019] [Accepted: 07/02/2019] [Indexed: 11/08/2022] Open
Abstract
Breast cancer can be diagnosed during pregnancy and in the peri-partum period, and the potential exposure of a foetus or neonate to chemotherapy is of concern to mothers and clinicians. Paclitaxel is a commonly used agent in breast cancer, but little is known about its excretion in breast milk. Breastfeeding during chemotherapy has been traditionally cautioned against due to the risk of neonatal exposure to chemotherapy agents, however, data are limited. We measured serum and breast milk concentrations of paclitaxel in a 33-year-old woman with an early breast cancer diagnosed during pregnancy and treated with weekly paclitaxel 80 mg/m2. We found breast milk paclitaxel levels drop below the minimum quantifiable dose at 72 h following chemotherapy, with a relative infant dose of 0.091%. Breast milk excretion of paclitaxel following a dose of 80 mg/m2 is negligible at 72 h, and this may be a safe time to recommence breastfeeding following exposure.
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7
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Zha N, Alabousi M, Abdullah P, Freitas V, Linthorst R, Muhn N, Alabousi A. Breast Cancer Screening in High-Risk Patients during Pregnancy and Breastfeeding: A Systematic Review of the Literature. JOURNAL OF BREAST IMAGING 2019; 1:92-98. [PMID: 38424914 DOI: 10.1093/jbi/wby015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 03/02/2024]
Abstract
There are currently no clear guidelines for high-risk breast cancer screening during the pregnancy and breastfeeding periods. The objective of this systematic review (SR) was to assess the available evidence pertaining to breast cancer screening recommendations in this population with the aim of supporting future guidelines. We performed a SR of the literature using the electronic databases MEDLINE and Embase. Predetermined inclusion and exclusion criteria were used during the abstract screening and full-text data extraction phases. We retrieved 2,274 abstracts after removal of duplicates, from which 16 studies were included based on predetermined eligibility criteria. Most of the studies found were narrative reviews and expert opinions. Clinical breast exam (CBE) was recommended by 12 studies during pregnancy and by 6 studies in the breastfeeding period. Mammography was recommended in the breastfeeding period by 2 studies. Magnetic resonance imaging was recommended in the breastfeeding period by 2 studies. Ultrasound was considered not appropriate for screening in this population. The information extracted from this SR is based primarily on expert opinion and anecdotal evidence, which explains the lack of standardized guidelines for high-risk breast cancer screening in this population. However, expert opinion may be a surrogate outcome for high-risk breast cancer screening recommendations in this subset of patients, and as such, may justify the clinical management to be tailored accordingly. This SR summarizes the evidence pertaining to high-risk breast cancer screening during pregnancy and breastfeeding, which could serve as a catalyst for future research on the topic.
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Affiliation(s)
- Nanxi Zha
- McMaster University, Department of Radiology, Hamilton, ON, Canada
| | - Mostafa Alabousi
- McMaster University, Department of Radiology, Hamilton, ON, Canada
| | - Peri Abdullah
- York University, Department of Kinesiology & Health Science, Toronto, ON, Canada
| | - Vivianne Freitas
- University of Toronto, Joint Department of Medical Imaging, Toronto, ON, Canada
| | - Rhys Linthorst
- McMaster University, DeGroote School of Medicine, Hamilton, ON, Canada
| | - Narry Muhn
- McMaster University, Department of Radiology, Hamilton, ON, Canada
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8
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Pereira N, Kligman I, Hunt R, Kopparam R, Wahmann B, Rosenwaks Z. Fertility preservation with random-start controlled ovarian stimulation and embryo cryopreservation for early pregnancy-associated breast cancer. Gynecol Endocrinol 2019; 35:214-216. [PMID: 30403906 DOI: 10.1080/09513590.2018.1522298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
We report a case of fertility preservation using random-start controlled ovarian stimulation (COS), intracytoplasmic sperm injection (ICSI) and embryo cryopreservation in a patient with early pregnancy-associated breast cancer. A 34-year-old nulliparous woman at 5 weeks of gestation was diagnosed with estrogen receptor (ER) positive, progesterone receptor (PR) positive and human epidermal growth factor receptor-2 (HER-2) negative infiltrating intraductal carcinoma. Urgent neoadjuvant chemotherapy was deemed necessary and the patient decided to terminate the pregnancy. Random-start COS was initiated 5 days after pregnancy termination using a letrozole-based protocol. The beta human chorionic gonadotropin level on the day of COS start was 119.8 mIU/mL. Twenty-nine oocytes were retrieved after 11 days of COS. Seventeen oocytes underwent successful fertilization and 10 blastocysts were cryopreserved. The patient subsequently initiated neoadjuvant chemotherapy with her oncologist. The current case highlights the feasibility of random-start COS and embryo cryopreservation for fertility preservation immediately after the termination of an early pregnancy in a patient with pregnancy-associated breast cancer.
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Affiliation(s)
- Nigel Pereira
- a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA
| | - Isaac Kligman
- a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA
| | - Rosalie Hunt
- a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA
| | | | - Bridget Wahmann
- a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA
| | - Zev Rosenwaks
- a The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine , Weill Cornell Medicine , New York , NY , USA
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9
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Khalil N, Fowler C. Misconceptions surrounding pregnancy-associated breast cancer. BMJ Case Rep 2018; 11:e226719. [PMID: 30567280 PMCID: PMC6301761 DOI: 10.1136/bcr-2018-226719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2018] [Indexed: 11/03/2022] Open
Abstract
This case report describes a 31-year-old woman who presented with a right painless breast lump. A mammogram and ultrasound scan showed the lump was suspicious of cancer. Core biopsy and immunohistochemistry of the lump confirmed a triple negative, poorly differentiated, invasive ductal carcinoma of the right breast. One week following her diagnosis, the patient found out she was pregnant. The patient was worried about what the implications this diagnosis would have on both her baby and her own cancer treatment.
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MESH Headings
- Adult
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/therapy
- Combined Modality Therapy
- Delivery, Obstetric
- Diagnosis, Differential
- Female
- Humans
- Infant, Newborn
- Mammography
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/diagnostic imaging
- Pregnancy Complications, Neoplastic/therapy
- Pregnancy Trimester, First
- Triple Negative Breast Neoplasms/diagnosis
- Triple Negative Breast Neoplasms/diagnostic imaging
- Triple Negative Breast Neoplasms/therapy
- Ultrasonography, Prenatal
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Affiliation(s)
- Nada Khalil
- University of Bristol Medical School, Bristol, UK
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10
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Current approaches in the clinical management of pregnancy-associated breast cancer-pros and cons. EPMA J 2018; 9:257-270. [PMID: 30174762 DOI: 10.1007/s13167-018-0139-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Abstract
Malignancies are one of the leading causes of mortality in women during their reproductive life. Treatment of gynecological malignant tumors during pregnancy is possible but not simple, since it creates a conflict between care of the mother and the fetus. BC is the most prevalent malignancy diagnosed in pregnancy, ranking up to 21% of all pregnancy-related malignancies. Due to its stets increasing prevalence, aggressive cancer subtype, and severe ethical and psychological aspects linked to the disease, experts raise an alarm for an acute necessity to improve the overall management of the PABC-the issue which has strongly motivated our current paper. Comprehensive research data and clinical experience accumulated in recent years have advanced our understanding of the disease complexity. PABC treatment must be individualized with an emphasis on optimal care of the mother, while observing standard treatment protocols with regard to safety of the fetus. Treatment protocols should be elaborated based on the individualized patient profile, bearing in mind the acute danger to the mother, maximizing the therapy efficacy and minimizing harmful effects to the fetus. Complex consulting on treatment options, their impacts on pregnancy and potential teratogenic effects requires tight "doctor-patient" collaboration. Complications that may arise due to the treatment of breast cancer in pregnancy require a multiprofessional expertise including oncologists, neonatologists, perinatologists, obstetricians, teratologists, and toxicologists, and an extensive psychological support throughout the pregnancy and after giving birth. Thereby, specifically psychological aspects of PABC diagnosis and follow-up are frequently neglected, being not yet adequately explored in the entire disease management approach. Herewith, we update the status quo regarding the currently available diagnostic modalities, complex treatment algorithms, and novel clinical approaches which altogether argue for an urgent necessity of a paradigm shift moving away from reactive to predictive, preventive, and personalized medical approach in the overall management of PABC meeting the needs of young populations, persons at high risk, affected patients, and families as the society at large.
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11
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Arasu VA, Kannan N, Krishnarao PM, Kuehner G, Kuan MC, Kim JC, Joe BN, Lee AY. Imaging the Breast in Pregnant or Lactating Women. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0267-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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12
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Peccatori FA, Lambertini M, Scarfone G, Del Pup L, Codacci-Pisanelli G. Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences. Cancer Biol Med 2018; 15:6-13. [PMID: 29545964 PMCID: PMC5842335 DOI: 10.20892/j.issn.2095-3941.2017.0146] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy (BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments.
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Affiliation(s)
| | - Matteo Lambertini
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
| | - Giovanna Scarfone
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
| | - Lino Del Pup
- Gynecologic Oncology Department, European Institute of Oncology, Milan 20141, Italy
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13
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Vallurupalli M, Partridge AH, Mayer EL. Treatment of Breast Cancer During Pregnancy. CURRENT BREAST CANCER REPORTS 2017. [DOI: 10.1007/s12609-017-0256-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Cohade C, Moreau J, Gatimel N, Gladieff L, Parinaud J, Leandri R. Follicular growth but absence of oocyte and cumulus maturation during ovarian stimulation in the days following surgical abortion: a case report. Gynecol Endocrinol 2017; 33:680-681. [PMID: 28452561 DOI: 10.1080/09513590.2017.1320386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
This paper is a case report on the results of an ovarian stimulation performed in the days following an induced abortion. A patient had breast cancer diagnosed during an early pregnancy. She had an induced abortion and had, before chemotherapy an ovarian stimulation, using rFSH and GnRH antagonist, followed by follicular puncture for oocyte for vitrification in the view of fertility preservation. No oocyte could be obtained despite a good hormonal and ultrasonographical follicular growth. This case report suggest that ovarian stimulation must be delayed after abortion to allow the maturation of oocyte-cumulus complexes.
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Affiliation(s)
| | - Jessika Moreau
- a Médecine de la Reproduction, CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine EA 3694, Université Paul Sabatier , Toulouse , France , and
| | - Nicolas Gatimel
- a Médecine de la Reproduction, CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine EA 3694, Université Paul Sabatier , Toulouse , France , and
| | - Laurence Gladieff
- c Institut Claudius Regaud, Institut universitaire du cancer de Toulouse , Toulouse , France
| | - Jean Parinaud
- a Médecine de la Reproduction, CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine EA 3694, Université Paul Sabatier , Toulouse , France , and
| | - Roger Leandri
- a Médecine de la Reproduction, CHU Toulouse , Toulouse , France
- b Groupe de Recherche en Fertilité Humaine EA 3694, Université Paul Sabatier , Toulouse , France , and
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15
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Triple Negative Breast Cancer in Pregnancy and Postpartum: Two Case Reports in Hispanic Women. Case Rep Obstet Gynecol 2015; 2015:856931. [PMID: 26448887 PMCID: PMC4584038 DOI: 10.1155/2015/856931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 08/24/2015] [Indexed: 12/29/2022] Open
Abstract
Objective. Despite studies suggesting that triple negative breast cancer is more often seen in women of African ancestry, we report here two cases of pregnancy associated triple negative breast cancer in Hispanic women. Cases. Case one is a 37-year-old female para 2-0-0-2, who presented with a left breast mass, at 19 weeks of gestation, the biopsy of which reported an invasive ductal carcinoma, found to be triple receptor negative. The patient underwent chemotherapy during the pregnancy and was delivered with a cesarean at 37 weeks for obstetric indication. After delivery, the patient completed her chemotherapy that was followed by radical mastectomy and radiotherapy. Case two is a 28-year-old female para 6-0-1-5, who presented while breast-feeding with signs and symptoms of mastitis, and an engorged and tender right breast, five months postpartum. However, the sonogram revealed a fluid filled cavity. Aspiration and cytology did not reflect an infection and were negative for malignancy. High suspicion and lack of improvement led to biopsy that identified an invasive ductal carcinoma, found to be triple negative. The patient underwent chemotherapy followed by modified radical mastectomy. Conclusions. Triple negative breast cancer, during pregnancy or postpartum, poses a unique challenge and requires a multidisciplinary team to optimize treatment for these women.
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16
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Datar RS, Pereira N, Anderson SH, Stillman J, Glassner MJ. Puerperal Fertility Preservation with Controlled Ovarian Stimulation and Embryo Cryopreservation for Pregnancy-Associated Breast Cancer. J Gynecol Surg 2015. [DOI: 10.1089/gyn.2014.0086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Radhika S. Datar
- Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA
| | - Nigel Pereira
- Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA
| | | | - Jacob Stillman
- Main Line Fertility and Reproductive Medicine, Bryn Mawr, PA
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17
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Beyer I, Mutschler N, Blum KS, Mohrmann S. Breast Lesions during Pregnancy - a Diagnostic Challenge: Case Report. Breast Care (Basel) 2015; 10:207-10. [PMID: 26557826 DOI: 10.1159/000381823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Palpable masses of the breast often occur during pregnancy and should be further investigated. The standard diagnostic during pregnancy is an ultrasound combined, if needed, with a core needle biopsy. Most lesions are benign in younger women but, nevertheless, the incidence of pregnancy-associated breast cancer is 1 in 3,000 deliveries and rising. CASE REPORT We report the case of a 24-year-old patient diagnosed with a palpable breast lesion at 37 weeks of gestation. An ultrasound was performed and the lesion was rated BI-RADS 4. The initial core needle biopsy showed a ductal carcinoma in situ. After delivery and ablactating, a mammography, breast magnetic resonance imaging and a second ultrasound-guided biopsy was performed. Due to the inconclusive imaging and histological results, a wide excision was performed and a juvenile papillomatosis was confirmed. No further resection was necessary as the initial margins were sufficient. CONCLUSION This case suggests that the diagnosis of masses of the breast during pregnancy and lactation can be quite difficult. Diagnosis should be confirmed by an excision biopsy and by histological examination through an experienced pathologist. As a significant proportion of papillomas contain malignant regions, an argument exists for the complete excision of all papillary tumours.
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Affiliation(s)
- Ines Beyer
- Department OB/GYN, University Hospital Duesseldorf, Germany
| | | | - Katrin S Blum
- Department OB/GYN, University Hospital Duesseldorf, Germany
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