373P - Pregnancy-associated breast cancer: chemotherapy during pregnancy

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Breast Cancer, Locally Advanced
Cancer in Pregnancy
Presenter Junko Kawano
Authors J. Kawano1, N. Hayashi2, A. Yoshida3, H. Yagata1, H. Yamauchi1
  • 1Breast Surgical Oncology, St. Luke’s International Hospital, 104-8560 - Tokyo/JP
  • 2Breast Surgery, St. Luke’s International Hospital, 104-8560 - Tokyo/JP
  • 3Breast Surgical Oncology, St. Luke's International Hospital, 104-8560 - Tokyo/JP

Abstract

Background

Pregnancy-associated breast cancer is a rare disease and treatment for these patients is a challenging problem. There are limited data about diagnosis and treatment for this disease, and outcome of fetuses who were exposed to chemotherapy during pregnancy.

Patients and methods

Forty-two pregnancy-associated breast cancer patients were treated from November 1999 to May 2012. We reviewed the data, including clinicopathological characteristics, therapeutic management, and fetal outcome of twenty-eight patients who received chemotherapy during pregnancy.

Results

Twenty-eight of the 42 patients (66.6%) were treated with chemotherapy during pregnancy. Patients' age ranged from 27 to 44 years (a mean age, 35 years). Fetal gestation age at diagnosis ranged from 6 to 28 weeks (a mean gestation age, 17.1 weeks). All of the 28 patients had invasive carcinoma. Thirteen of the patients (46%) had ER-positive (ER+) and HER2-negative (HER-) tumors, 3 (10.7%) had ER + /HER2+ tumors, 3 (10.7%) had ER-/HER2+ tumors, and 10 (35.7%) had ER-/HER2- tumors. At diagnosis, 6 of the 28 patients (21.4%) were classified as having stage I, 14 (50%) as stage II, 6 (21.4%) as stage III, and 2 (7.1%) as stage IV. All patients started to receive chemotherapy at second and third trimesters. Ten patients received fluorouracil, doxorubicin, and cyclophosphamide (FAC), 16 patients received doxorubicin and cyclophosphamide (AC). Two patients with stage IV disease received taxanes (paclitaxel). For one of the two patients with stage IV disease, trastuzumab was added with careful monitoring for occurrence of oligohydramnios. Twenty-six of the 28 patients had delivered at a gestation age of at least 35 weeks (a mean gestation age, 37.6; range, 35-42 weeks). Two patients have not delivered yet up to this period. No congenital malformations or delay of fetal development were observed. Conclusion: Our data revealed that breast cancer can be treated with AC/FAC chemotherapy during the second and third trimesters without significant complications for the fetus. Further study is needed to confirm the safety use of taxanes and trastuzumab for these populations.

Disclosure

All authors have declared no conflicts of interest.