2023, Number 09
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Ginecol Obstet Mex 2023; 91 (09)
Metastatic breast cancer and pregnancy: a case report
Salas GEB, Barbabosa VJA, Palestino RG
Language: Spanish
References: 11
Page: 676-686
PDF size: 495.74 Kb.
ABSTRACT
Background: Breast cancer is the second most common malignancy associated
with pregnancy. Its treatment is complex due to fetal risks in the context of treatment
of the mother.
Clinical case: 28-year-old patient, referred from the Naval Hospital of Chetumal,
Quintana Roo, with 13.1 weeks of pregnancy by date of last menstrual period. The
CT scan showed a 70% pleural effusion, another pericardial effusion and suspicion of
osteoblastic metastasis to the thoracic spine. Physical examination showed ventilatory
dynamics, decreased right amplexion and amplexation, interscapular and right basal
hypoventilation, with decreased voice transmission, right basal submatitis and, to the
left side, a vesicular murmur. Cytochemical and cytological studies of pericardial and
pleural fluid were positive for malignancy. MRI of the spine showed lesions suggestive
of tumor activity in the vertebral bodies T12 to L5. Due to the advanced metastatic
stage of the cancer, termination of pregnancy was proposed in order not to delay treat-ment. The biological profile reported: triple negative immunophenotype (estrogen and
progesterone receptors: negative, HER2: negative in neoplastic cells). Treatment with
systemic chemotherapy (carboplatin-paclitaxel) was indicated.
Conclusion: The diagnosis of breast cancer during pregnancy hinders the detection
and interpretation of breast abnormalities, delays diagnosis, allows tumor growth
and increases the metastatic risk of the disease. Adequate oncologic treatment and its
multidisciplinary assessment are decisive in favoring survival.
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