Ruatta Fiorella, Denaro Nerina, Vanella Paola, Tomasello Gianluca, Principe Ernesto, Sciancalepore Grazia, Rea Carmen Giusy, Garrone Ornella
Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, 20122, Italy.
Medical Oncology, S. Croce E Carle Teaching Hospital, Cuneo, 12100, Italy.
Onco Targets Ther. 2024 Oct 9;17:821-827. doi: 10.2147/OTT.S464860. eCollection 2024.
The diagnosis of breast cancer during pregnancy is a rare event, but it is more frequent in our daily clinical practice due to the progressing aging of pregnant women. The management of a woman affected by pregnancy-associated breast cancer (PABC) remains a challenge for the clinician as it is related to ethical and psychological decisions.
Here, we retrospectively described 10 cases of PABC in women treated at our Institution. All cases were discussed in the multidisciplinary team. We reviewed available literature data on the topic.
Nine out 10 patients were diagnosed with localized breast cancer. The remaining patients were presented with metastatic de novo disease. Median age was 37.5 years (range 26-42). Seven patients presented with grade 3 tumor and 9 patients had Ki-67 value higher than 30%. All but 2 patients received neoadjuvant chemotherapy consisting of sequential anthracyclines and cyclophosphamide followed by weekly paclitaxel during pregnancy. No safety concerns or complications during delivery for both the mothers and the babies were reported.
Breast cancer during pregnancy is a challenging clinical situation and all the decisions need to consider both the patients and the fetus safety. Data from our series and from literature confirm the safety of standard chemotherapy approach starting from the second trimester of gestation. More research and effort are needed to offer these patients excellent outcomes and it is mandatory that cases should be closely followed up by a multidisciplinary team.
孕期乳腺癌的诊断较为罕见，但随着孕妇年龄增长，在我们的日常临床实践中其发生率越来越高。对于受妊娠相关乳腺癌（PABC）影响的女性进行管理，对临床医生而言仍是一项挑战，因为这涉及伦理和心理决策。
在此，我们回顾性描述了在我们机构接受治疗的10例PABC女性患者。所有病例均在多学科团队中进行了讨论。我们查阅了关于该主题的现有文献数据。
10例患者中有9例被诊断为局限性乳腺癌。其余患者表现为新发转移性疾病。中位年龄为37.5岁（范围26 - 42岁）。7例患者为3级肿瘤，9例患者的Ki-67值高于30%。除2例患者外，所有患者在孕期接受了新辅助化疗，方案为序贯使用蒽环类药物和环磷酰胺，随后每周使用紫杉醇。未报告母亲和婴儿在分娩期间有安全问题或并发症。
孕期乳腺癌是一种具有挑战性的临床情况，所有决策都需要考虑患者和胎儿的安全。我们系列研究及文献中的数据证实了从妊娠中期开始采用标准化疗方法的安全性。需要更多的研究和努力为这些患者提供良好的治疗结果，并且必须由多学科团队对病例进行密切随访。
