title: [Breast cancer during pregnancy and chemotherapy: a systematic review].
abstract: This study aimed to establish the safety of chemotherapy use in pregnant women with breast cancer, and to find possible effects in the fetus. A search of MEDLINE/PubMed, LILACS, SciELO, Cochrane, UpToDate, and Google Scholar databases was performed to identify publications, 86 articles published from 2001 to 2012 were retrieved and evaluated by two readers in accordance predetermined exclusion and inclusion criteria; 39 articles were selected. All the chemotherapy drugs used to treat breast cancer during pregnancy belonged to class D, and consisted of 5-fluorouracil (F), doxorubicin (A) or epirubicin (E) and cyclophosphamide (C), or the combination doxorubicin and cyclophosphamide (AC), a safe regimen when used after the first trimester of pregnancy. Few studies evaluated the use of taxanes (T), such as docetaxel (D) and paclitaxel (P), with no increase in the occurrence of fetal defects and other maternal complications when used in the second and third trimesters of pregnancy. The use of trastuzumab in pregnant women is associated with oligohydramnios and anhydramnios; thus, it is not recommended during pregnancy. As almost all studies were observational and retrospective, new prospective studies on the subject are needed.
authors.affiliation: Centro Universitário Serra dos Órgãos, Teresópolis, RJ, Brasil. denimonteiro2@yahoo.com.br
authors.forename: Denise Leite Maia
authors.initials: DL
authors.lastname: Monteiro
authors.forename: Alexandre José Baptista
authors.initials: AJ
authors.lastname: Trajano
authors.forename: Daniela Contage Siccardi
authors.initials: DC
authors.lastname: Menezes
authors.forename: Norma Luiza Machado
authors.initials: NL
authors.lastname: Silveira
authors.forename: Alessandra Caputo
authors.initials: AC
authors.lastname: Magalhães
authors.forename: Fatima Regina Dias de
authors.initials: FR
authors.lastname: Miranda
authors.forename: Barbara
authors.initials: B
authors.lastname: Caldas
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents