title: Management of Breast Cancer during Pregnancy: Are We Compliant with Current Guidelines?
abstract: IntroductionThe purpose of this study was to evaluate the management of patients with breast cancer in pregnancy treated at the Advocate Health Care, to determine whether these patients were treated according to guidelines for pregnant patients, which aim to maximize both fetal and maternal outcomes.MethodsA retrospective chart review was performed at the Advocate Lutheran General Hospital, Christ Medical Center, and Illinois Masonic Medical Center from 2002 to 2012 on patients diagnosed with breast cancer during pregnancy using ICD-9 (International Classification of Diseases - 9th version) codes.ResultsEleven patients between 12 and 37 weeks' gestation matched the search criteria. One patient terminated the pregnancy. Patients in our study were treated appropriately according to guidelines with the following exceptions. Trastuzumab was used in one patient during pregnancy which likely caused the oligohydramnios resulting in an induction of labor at 33 weeks. Three patients were delivered preterm between 34 and 36 weeks without an obstetric indication. Two patients underwent sentinel node biopsy.ConclusionThe diagnosis of breast cancer in pregnancy is an infrequent but devastating diagnosis that is likely to increase. Although sentinel lymph node biopsy is not generally recommended in pregnancy, this may be an outdated guideline as using a low-dose lymphoscintigraphic technique appears to be safe in pregnancy.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois.
authors.forename: Victoria
authors.initials: V
authors.lastname: Shlensky
authors.affiliation: Division of Hematology and Oncology, Center for Advanced Care, Advocate Lutheran General Hospital, Park Ridge, Illinois.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Hallmeyer
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Juarez
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois.
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Parilla
keywords: breast cancer; chemotherapy; pregnancy; sentinel node biopsy