2019, Number 05
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Ginecol Obstet Mex 2019; 87 (05)
Treatment of breast cancer in pregnant women: clinical case
Montaño-Serrano M, Rojo-Novo S, Albalat-Fernández R, Novo-Cabrera J, La Calle-Marcos M
Language: Spanish
References: 22
Page: 324-333
PDF size: 381.72 Kb.
ABSTRACT
Background: Breast cancer is the most prevalent cancer nowadays and is the most
common at the pregnancy and postpartum period. The incidence is between 0.2-2.6%
and is currently increasing due to delayed childbearing. The treatment implies a challenge
for the health systems because the welfare of the mother and her child must be
valued and safeguarded.
Clinical case: A 26-year-old patient who attended the consultation for right mastalgia,
with rapid growth from the beginning of pregnancy. During the mammary examination,
a hard consistency tumor of 8 cm was observed, occupying both upper quadrants of
the right breast, with reddening of the skin. The ultrasound revealed a heterogeneous
solid-cystic tumor, 8 x 5 cm, without pathological axillary lymph nodes. The anatomopathological
study of the biopsy reported an infiltrating carcinoma, with triple negative
immunophenotype (negative immunoreactivity for estrogen and progesterone receptors,
and Her-2 with Ki67 proliferation index of 80%), which confirmed the diagnosis of
breast cancer locally advanced in the second trimester of pregnancy. After administration
of three cycles of neoadjuvant chemotherapy with anthracyclines (doxorubicin and
cyclophosphamide) trisemanales, termination of pregnancy was indicated by induction
of labor at week 36 + 6. A male was born at 2800 g, with Apgar 9-10- 10 The mother
and her son evolved satisfactorily, so they were discharged 4 days after the intervention.
Ten months after mastectomy, she enjoys good physical and psycho-logical health, as
does her 15-month-old son. Continues in close monitoring in the Oncology service.
Conclusions: The treatment of breast cancer during pregnancy is safe and offers
good long-term results. The important intervention and multidisciplinary assessment,
in addition to the correct advice and psychological support to the family.
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