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Federación Mexicana de Ginecología y Obstetricia, A.C.

2015, Number 04

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Ginecol Obstet Mex 2015; 83 (04)

Clinical evaluation of patients with breast cancer and pregnancy

Rojo-Contreras W, Balderrama-Ibarra R, Salas-Gonzále E, Salazar-Páramo M

Language: Spanish
References: 17
Page: 213-219
PDF size: 323.80 Kb.


ABSTRACT

Background: Breast cancer is the second most common malignancy diagnosed in pregnancy. Breast cancer in pregnancy represents a challenge in diagnosis as well as in treatment.
Objective: To evaluate clinically patients with breast cancer in pregnancy.
Meterial and methods: Retrospective, transversal, descriptive study was done in which we enrolled women with breast cancer and pregnancy from the outpatient clinic of medical oncology of a tertiary care center hospital. Statistical analysis: descriptive statistics.
Results: The variables of 15 clinical records were examined, median age 33.3 ± 5.5 years, tobacco use 3/15, oral contraceptives use 2/15, age at first birth 25.8 ± 7 years, breastfed 4/15. The initial medical evaluation was done 7.5 ± 7.7 months after the onset of symptoms, the diagnosis was made with trucut biopsy in 9/15 of patients, excisional biopsy 4/15 and fine needle aspiration biopsy 2/15. Clinical stage was IIA 3/15, IIIA 8/15, IIIB 3/15 and IV 1/15. Six patients were treated with chemotherapy during pregnancy in the second and third trimester and three with surgical treatment. There were no fetal deaths related to treatment. Response to treatment: 8/15 are disease-free, 5/15 progressed to death and 2/15 had bone metastasis.
Conclusion: Even major cancer centers have limited experience with breast cancer in pregnancy. Medical and surgical treatment should not be differed. More prospective studies are needed to assess factors related to treatment and prognosis.


REFERENCES

  1. Estadística INEGI 2012 Cáncer de mama - http://www.inegi. org.mx/inegi/contenidos/espanol/prensa/Contenidos/ estadisticas/2014/mama0.pdf

  2. Peccatori FA, Azim HA, Orecchia R, Hoekstra HJ, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24(6):160-170.

  3. Sánchez C, Acevedo F, Medina L, Ibáñez C, et al. Breast cancer and pregnancy: a comparative analysis of a Chilean cohort. ecancer 2014;8:434-441.

  4. Antonelli NM, Dotters DJ, Katz VL, Kuller JA. Cancer in pregnancy: A review of the literature. Part I. Obstet Gynecol Surv 1996;51(2):125-134.

  5. Doger E, Caliskan E, Mallmann P. Pregnancy associated breast cancer and pregnancy after breast cancer treatment. J Turk Ger Gynecol Assoc 2011; 12: 247-255.

  6. Beral V, Bull D, Doll R, Peto R, et al. Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83 000 women with breast cancer from 16 countries. Lancet 2004;363(9414):1007-1016.

  7. Elledge RM, Ciocca DR, Langone G, McGuire WL. Estrogen receptor, progesterone receptor, and HER-2/neu protein in breast cancers from pregnant patients. Cancer 1993;71(8):2499-2506.

  8. León-Villalba JC, López-Graniel CM, Lara-Medina F, Calderón G, et al. Cáncer y embarazo: experiencia en el Instituto Nacional de Cancerología de México. Rev. Inst. Nac. Cancerol 1999;45(3):144-152.

  9. Petrek, Theriault. Diseases of the breast. Tercera edición. Estados Unidos:Harris J, Williams & Wilkins 2004:1035- 1046.

  10. Litton JK, Theriault RL, Gonzalez-Angulo AM. Breast cancer diagnosis during pregnancy. Womens Health 2009;5(3): 243–249.

  11. Moore HC, Foster RS Jr. Breast cancer and pregnancy. Semin Oncol 2000;27(6):646-653.

  12. A Avilés, N Neri. Hematological Malignancies and Pregnancy: A Final Report of 84 Children Who Received Chemotherapy In Utero. Clinical lymphoma, 2001;2:173-177

  13. Gobierno Federal. Norma Oficial Mexicana NOM-041- SSA2-2011, Para la prevención, diagnóstico, tratamiento, control y vigilancia epidemiológica del cáncer de mama. México: Secretaría de Salud. Disponible en: http:// dof.gob.mx/nota_detalle.php?codigo=5194157&fec ha=09/06/2011

  14. Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 2003;189(4):1128- 1135.

  15. Berry DL, Theriault RL, Holmes FA, Parisi VM, et al. Management of breast cancer during pregnancy using a standardized protocol. J Clin Oncol 1999;17(3):855-861.

  16. Nettleton J, Long J, Kuban D, Wu R, et al. Breast cancer during pregnancy: quantifying the risk of treatment delay. Obstet Gynecol 1996;87(3):414-418.

  17. Johansson AL, Andersson TM, Hsieh CC, Jirström K, et al. Stage at diagnosis and mortality in women with pregnancyassociated breast cancer (PABC). Breast Cancer Res Treat 2013;139(1):183-192.




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