Surgery and chemotherapy are possible for pregnant women with breast cancer
Breast cancer in pregnant women is as common as in non-pregnant women of the same age, with no evidence to suggest pregnancy increases the risk of such cancer. In the majority of cases, pregnant women can have their breast cancer treated with surgery or chemotherapy or both, and the aim in most cases should be a normal length pregnancy to avoid the harm to the unborn child that can be caused by premature birth. Termination of the pregnancy does not improve the outcome for the mother. The issues around this delicate subject are discussed in the second paper in The Lancet Series on cancer in pregnancy, written by Dr Frédéric Amant, Multidisciplinary Breast Cancer Center, Leuven Cancer Institute, Katholieke Universiteit Leuven, Belgium, and colleagues.
Normal physiological changes in pregnancy, such as breasts increasing in size and nipple discharge, can obscure symptoms of breast cancer for both the woman and her doctor. Thus breast cancer in pregnancy is usually diagnosed later than in non-pregnant women, and with worse outcomes.
Radiation therapy is not generally advised during pregnancy, especially later in pregnancy where it becomes more difficult to shield the fetus. However chemotherapy can be given as per standard guidelines for non-pregnant women in the second and third trimesters. In most cases, radiotherapy only becomes necessary after the woman has given birth (but should not be used as a reason to deliver the baby prematurely). There is no evidence to suggest chemotherapy given correctly harms the unborn child (see linked paper in The Lancet Oncology) The authors also advise that the placenta be examined after birth to check for evidence of the spread of cancer (metastases), and that breastfeeding in the first weeks after chemotherapy cannot be recommended.
"The situation remains challenging since in some situations an advanced cancer can be fatal for mother and fetus," says Dr Amant.* "In other situations we were able to save the child though we lost the mother immediately after the delivery, for example by keeping her alive with a terminal brain tumour. Sometimes the woman's partner declares that they feel unable to raise the child in case the mother would not survive her cancer and termination of pregnancy is opted for."
But he adds*: "Importantly, the new insights we gained during our research facilitate cancer treatment and provide hope for mother and child in most cases. Most mothers feel stronger and are even more motivated to undergo the cancer treatment and its side effects, since she is fighting for her child as well."
The authors say*: "Whether the patient already has children, her desire to continue the present pregnancy, the opinion of the partner and the predicted outcome determine her choices and reactions when breast cancer is diagnosed during pregnancy. The patient and her partner should be informed about the different treatment options and the physician should explain that termination of pregnancy does not seem to improve maternal outcome, but the decision to continue or end the pregnancy is a personal one."
They add: "Breast cancer during pregnancy is not an emergency and the time needed to consult an expert team does not worsen the prognosis. The first multidisciplinary discussion should consider a diagnostic strategy aiming to reduce the burden of fetal radiation exposure. Non-ionising examinations are preferred to those needing ionising agents, and staging examinations that are likely to alter breast cancer treatment during pregnancy are done."
They conclude: "Breast cancer staging and treatment are possible during pregnancy, and should be defined in a multidisciplinary setting
Cancer treatment during pregnancy will decrease the need for early delivery and thus prematurity, which is a major concern in management of breast cancer in pregnancy."
More information: www.thelancet.com/… in-pregnancy
Provided by Lancet
- Pregnancy Has No Impact On Breast Cancer, But Can Delay Diagnosis And Treatment Feb 09, 2009 | not rated yet | 0
- Unique needs and outcomes of pregnant women with breast cancer identified Dec 11, 2010 | not rated yet | 0
- Study: Pregnancy safe for breast cancer survivors Mar 26, 2010 | not rated yet | 0
- Pregnant women can receive breast cancer chemotherapy without endangering health of their babies Mar 25, 2010 | not rated yet | 0
- Clues to pregnancy-associated breast cancer found Mar 29, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Assumptions of Griffith's fracture theory
7 hours ago Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
Current leading voltage or vice versa concept
9 hours ago Hello, I was wondering if there is a conceptual explanation for when current leads voltage or vice versa for capacitors or inductors with AC...
Angular Frequency of AC voltage
12 hours ago Hello, I am wondering, what is the physical interpretation of the angular frequency of AC voltage? I don't see the physicality of what the angle...
Modeling Rigid Body - Unsure about Euler angles and angular velocity
12 hours ago I'm modeling a single 3D rigid body in preparation for some more complicated modeling in order to gain a better understanding of Euler angles, the...
Function for a bullet's path
14 hours ago I've been mulling this over all weekend, and I've decided to get some help on this. The problem is writing a function to describe a bullet's path....
Elementary questions relating to Newton's laws of motion
15 hours ago i) If a wall breaks when it gets hit by a cannonball, did the wall exert an equal and opposite force on the cannonball? ii) Would the force...
- More from Physics Forums - Classical Physics
More news stories
Posterior fossa subdural hematoma (PFSDH) is a serious and rare condition in newborns, generally occurring after difficult deliveries. But with appropriate treatment, there's an excellent chance of good long-term outcomes ...
Surgery 21 hours ago | not rated yet | 0
Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. ...
Surgery May 17, 2013 | not rated yet | 0
(HealthDay)—About 65 percent of surgical residents report that they disapprove of the 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements, which place restrictions ...
Surgery May 16, 2013 | not rated yet | 0
Metal-on-metal hip implants can cause inflammation of the joint lining (synovitis) long before symptoms appear, and magnetic resonance imaging (MRI) can be used to identify this inflammation, according to ...
Surgery May 15, 2013 | not rated yet | 0
Obese patients who received robotic kidney transplants had fewer wound complications than patients who received traditional "open" transplant surgery, according to surgeons at the University of Illinois Hospital ...
Surgery May 15, 2013 | not rated yet | 0
In a remote fishing community in Venezuela, a lone fisherman sits on a cliff overlooking the southern Caribbean Sea. This man –– the lookout –– is responsible for directing his comrades on the water, ...
59 minutes ago | not rated yet | 0 |
A novel approach to obstructing the runaway inflammatory response implicated in some types of asthma has shown promise in a Phase IIa clinical trial, according to U. S. researchers.
53 minutes ago | not rated yet | 0
Authorities are investigating rice mills in southern China following tests that found almost half of the staple grain in one of the country's largest cities was contaminated with a toxic metal.
58 minutes ago | not rated yet | 0
Clinical measurement of physical activity appears to be an independent predictor of whether or not patients with chronic obstructive pulmonary disease (COPD) will end up being hospitalized, according to a new study conducted ...
38 minutes ago | not rated yet | 0
Delayed transfer to the intensive care unit (ICU) in hospitalized patients significantly increases the risk of dying in the hospital, according to a new study from researchers in Chicago.
18 minutes ago | not rated yet | 0
Treatment with an Alpha-1 proteinase inhibitor (A1-PI), a naturally occurring protein that protects lung tissue from breakdown and protects the lung's elasticity, is effective in slowing the progression of emphysema in patients ...
51 minutes ago | not rated yet | 0