Breast carcinoma during pregnancy. International recommendations from an expert meeting.
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).


CONCLUSIONS
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.
Loibl
Sibylle
S
Department of Obstetrics and Gynaecology, J.W.-Goethe University, Frankfurt am Main, Germany. Loibl@em.uni-frankfurt.de
von Minckwitz
Gunter
G
Gwyn
Karin
K
Ellis
Paul
P
Blohmer
Jens U
JU
Schlegelberger
Brigitte
B
Keller
Monika
M
Harder
Sebastian
S
Theriault
Richard L
RL
Crivellari
Diana
D
Klingebiel
Thomas
T
Louwen
Frank
F
Kaufmann
Manfred
M
D018943:Anthracyclines / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011256:Pregnancy Outcome; D011379:Prognosis; D043823:Taxoids / Q000633:toxicity
D018943:Anthracyclines; D043823:Taxoids