Chemotherapy with epirubicin and paclitaxel for breast cancer during pregnancy: case report and review of the literature.
BACKGROUND
Breast cancer diagnosed during pregnancy is a challenging clinical situation. Little data are currently available about chemotherapy in pregnant women with this malignancy.


METHODS
We report the case of a 36-year-old pregnant woman with a T2N1M0 breast cancer who received sequential chemotherapy including epirubicin (120 mg/m2 every three weeks for four cycles) and paclitaxel (175 mg/m2 every three weeks for three cycles) from the 14th to the 32nd week of gestation. The patient delivered a normal female baby by caesarean section at the 36th week. The immunohistochemical examination of the placenta showed a diffuse, strong P-glycoprotein expression. Thirty-six months after the delivery, the mother was disease-free and the infant showed normal development and growth.


CONCLUSIONS
Sequential chemotherapy including epirubicin and paclitaxel should be taken into consideration as adjuvant treatment for pregnant women with high-risk breast cancer. The strong placental expression of P-glycoprotein may play a major role in limiting fetal exposure to anthracyclines and taxanes.
Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Via Roma 67, 56127 Pisa, Italy. a.gadducci@obgyn.med.unipi.it
Angiolo
A
Gadducci
Stefania
S
Cosio
Antonio
A
Fanucchi
Vincenzo
V
Nardini
Manuela
M
Roncella
Pier Franco
PF
Conte
Andrea Riccardo
AR
Genazzani
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000096:biosynthesis; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000378:metabolism
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D015251:Epirubicin; D017239:Paclitaxel