Breast cancer and pregnancy: challenges of chemotherapy.
BACKGROUND
Breast cancer is the second most frequently occurring malignancy during pregnancy. As evidence-based data on diagnostics and treatment is lacking, current recommendations mostly derive from nonrandomized experiences. We reviewed the current literature with focus on chemotherapy during pregnancy and lactation.


RESULTS
The diagnosis of pregnancy associated breast cancer implies the challenge to balance between a life-saving therapy for the mother's breast cancer and a potentially life-threatening therapy for the fetus. With few limitations, surgery and chemotherapy can be performed during pregnancy, preferably in the second and third trimester, whereas radiotherapy and endocrine or antibody treatment should be postponed until after delivery.


CONCLUSIONS
Breast cancer during pregnancy and lactation remains a therapeutic and ethical multidisciplinary challenge. Close cooperation between all disciplines is inevitable to find an optimal treatment strategy for the mother and her unborn child.
Lenhard
Miriam S
MS
Department of Obstetrics and Gynecology, Campus Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 80337 Munich, Germany. Miriam.Lenhard@med.uni-muenchen.de
Bauerfeind
Ingo
I
Untch
Michael
M
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007774:Lactation; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D011256:Pregnancy Outcome; D011379:Prognosis; D016896:Treatment Outcome
D000970:Antineoplastic Agents