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Breast carcinoma during pregnancy

International recommendations from an expert meeting

  1. Sibylle Loibl M.D.1,†,*,
  2. Gunter von Minckwitz M.D.1,2,
  3. Karin Gwyn M.D.3,
  4. Paul Ellis M.D.4,
  5. Jens U. Blohmer M.D.5,
  6. Brigitte Schlegelberger M.D.6,
  7. Monika Keller M.D.7,
  8. Sebastian Harder M.D.8,
  9. Richard L. Theriault D.O., M.B.A.3,
  10. Diana Crivellari M.D.9,
  11. Thomas Klingebiel M.D.10,
  12. Frank Louwen M.D.1,
  13. Manfred Kaufmann M.D.1

Article first published online: 9 DEC 2005

DOI: 10.1002/cncr.21610

Issue

Cancer

Cancer

Volume 106, Issue 2, pages 237–246, 15 January 2006

Additional Information

How to Cite

Loibl, S., von Minckwitz, G., Gwyn, K., Ellis, P., Blohmer, J. U., Schlegelberger, B., Keller, M., Harder, S., Theriault, R. L., Crivellari, D., Klingebiel, T., Louwen, F. and Kaufmann, M. (2006), Breast carcinoma during pregnancy. Cancer, 106: 237–246. doi: 10.1002/cncr.21610

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, J.W.-Goethe University, Frankfurt am Main, Germany

  2. 2

    German Breast Group, Neu-Isenburg, Germany

  3. 3

    Department of Breast Medical Oncology, M.D. Anderson Cancer Center, The University of Texas, Houston, Texas

  4. 4

    Department of Medical Oncology, Kings, St Thomas' Cancer Centre, Guy's Hospital, London, UK

  5. 5

    St. Gertrauden, Berlin, Germany

  6. 6

    Institute of Cell and Molecular Pathology, Medizinische Hochschule Hannover, Hannover, Germany

  7. 7

    Department of Surgery, Psychosocial Care Unit, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany

  8. 8

    Institute for Clinical Pharmacology at the Pharmazentrum, J.W.-Goethe University, Frankfurt am Main, Germany

  9. 9

    Division of Medical Oncology C, Centro di Riferimento Oncologico, Aviano, Italy

  10. 10

    Department of Paediatric Oncology, J.W.-Goethe University, Frankfurt am Main, Germany

  1. †

    Fax: (011) 49-69-6301-7938

*J.W.-Goethe University, Department of Obstetrics and Gynaecology, Theodor-Stern-Kai 7; 60590 Frankfurt am Main, Germany

Publication History

  1. Issue published online: 5 JAN 2006
  2. Article first published online: 9 DEC 2005
  3. Manuscript Accepted: 11 AUG 2005
  4. Manuscript Revised: 16 JUL 2005
  5. Manuscript Received: 9 MAY 2005

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Keywords:

  • breast carcinoma;
  • pregnancy;
  • recommendation;
  • chemotherapy

The treatment of breast carcinoma during pregnancy should conform as closely as possible to standardized protocols for patients without concomitant pregnancy

Abstract

BACKGROUND

Breast carcinoma during pregnancy (BCP) is a difficult clinical situation, as it appears to put the health of the mother in conflict with that of the fetus.

METHODS

An international expert meeting was conducted to form guidelines on how to diagnose and treat women with BCP.

RESULTS

The goal for treatment of the pregnant woman with breast carcinoma is the same as that of the nonpregnant breast carcinoma patient: local control of disease and prevention of systemic metastases. However, certain treatment modalities need to be modified because of the potential for adverse effects on the fetus. There is evidence to support the safety of anthracycline-based chemotherapy during the second and third trimesters of pregnancy (Oxford Level of Evidence [LOE] 2b). Because of the lack of evidence, the expert opinion was not to recommend the routine use of newer cytotoxic drugs like the taxanes during pregnancy (LOE 5).

CONCLUSION

The recommendations provided should help to reach informed decision making by the patient. The ongoing prospective collection of data on BCP, such as that at the University of Texas M.D. Anderson Cancer Center (UTMDACC) and that of the German Breast Group/Breast International Group (GBG/BIG), is necessary to further our knowledge regarding the treatment of this unique group of breast carcinoma patients. Cancer 2006. © 2005 American Cancer Society.

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