title: Exploring the safety of chemotherapy for treating breast cancer during pregnancy.
abstract: BACKGROUND
  The diagnosis of breast cancer during pregnancy (BCP) represents a unique challenge to the patient, her family and the treating physician. The proper management of this critical clinical situation is crucial, and requires a multidisciplinary approach. A proper understanding of the safety of chemotherapy during pregnancy is a vital step to avoid detrimental consequences on the mother and the fetus.
  
  
  METHODS
  The aim of this article is to review the available evidence on the safety of chemotherapy administration in managing BCP.
  
  
  CONCLUSIONS
  The rule of thumb of chemotherapy - avoiding first trimester exposure and starting therapy in the second trimester - can be considered applicable for classic agents that are used in managing pregnant breast cancer patients. Anthracycline-based regimens are considered the standard of care in managing BCP. Recently, a growing amount of data suggests the safety of taxanes during pregnancy. Pregnancy in cancer patients should be considered as "high risk": once the systemic treatment is initiated, regular fetal monitoring is highly recommended. Emerging data are available on the relative long-term safety secondary to anthracycline exposure during pregnancy. A continued monitoring of the health of individuals with prenatal exposure to chemotherapy into adulthood is recommended for the possible occurrence of long-term side effects.
authors.affiliation: a 1 Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST , Genova, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lambertini
authors.forename: Nermine S
authors.initials: NS
authors.lastname: Kamal
authors.forename: Fedro A
authors.initials: FA
authors.lastname: Peccatori
authors.forename: Lucia
authors.initials: L
authors.lastname: Del Mastro
authors.forename: Hatem A
authors.initials: HA
authors.lastname: Azim
mesh_terms: D000818:Animals; D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000473:pathology; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents
keywords: anthracycline; breast cancer during pregnancy; chemotherapy; fetal and child monitoring; taxanes