title: Multidisciplinary approach to breast cancer diagnosed during pregnancy: maternal and neonatal outcomes.
abstract: OBJECTIVE
  We assessed maternal and neonatal outcome in women diagnosed with breast cancer during pregnancy.
  
  
  METHODS
  Retrospective single-centre cohort study of 25 consecutive pregnant women (mean age 36 years) diagnosed and treated for breast cancer between 2000 and 2011. Management was individualized according to type of tumor and time of gestation at diagnosis.
  
  
  RESULTS
  Twelve patients were diagnosed during the second trimester. BI-RADS category <3 mammographic lesions were diagnosed in 7 patients. A suspicious area was detected by ultrasound in 20 of 21 women who underwent ultrasound studies. Nineteen patients had positive hormone receptors and 7 sobreexpressed HER2. One patient was in stage 0, 8 in stage I, 8 in stage II, 3 in stage III and 5 in stage IV. Four patients decided voluntarily to legally terminate their pregnancies, one had a spontaneous miscarriage and in three patients, pregnancy was interrupted at the end of the third trimester before oncological treatment. Eleven patients were treated with chemotherapy during pregnancy after the second trimester using anthracycline-based regimens. In five patients the pregnancy was ended before 34 weeks of gestation. Nine patients had gestation-related complications, including preterm labor, pneumonia, increase in velocity of the middle cerebral artery, oligohydramnios, preeclampsia, extreme prematurity, intrauterine growth restriction, dyspnea, spontaneous miscarriage and chemotherapy-related granulocytopenia. Betamethasone to stimulate fetal lung maturation was used in 6 patients.
  
  
  CONCLUSIONS
  Breast cancer women diagnosed during pregnancy presented a high number of complications unrelated to antineoplastic treatment. A multidisciplinary team approach is necessary for satisfactory neonatal results.
authors.affiliation: Vall d'Hebron Breast Cancer Center, Service of Gynecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain. ocordoba@vhebron.net
authors.forename: Octavi
authors.initials: O
authors.lastname: Córdoba
authors.forename: Elisa
authors.initials: E
authors.lastname: Llurba
authors.forename: Cristina
authors.initials: C
authors.lastname: Saura
authors.forename: Isabel
authors.initials: I
authors.lastname: Rubio
authors.forename: Queralt
authors.initials: Q
authors.lastname: Ferrer
authors.forename: Javier
authors.initials: J
authors.lastname: Cortés
authors.forename: Jordi
authors.initials: J
authors.lastname: Xercavins
mesh_terms: D000028:Abortion, Induced; D000022:Abortion, Spontaneous; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008197:Lymph Node Excision; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents