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Breast cancer in pregnancy

Mammakarzinom während der Schwangerschaft

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Zusammenfassung

GRUNDLAGEN: Die erhöhte Häufigkeit von Mammakarzinom während der Schwangerschaft (Inzidenz 0,2–3,8 %) erklärt sich teilweise durch das höhere Alter der Frauen bei der ersten Schwangerschaft. Diese Koinzidenz ist wahrscheinlicher bei BRCA1- und möglicherweise auch BRCA2-Mutationen, welche die Entstehung des Mammakarzinoms in jugendlichem Alter begünstigt. METHODIK: Es wurde eine PubMed-Analyse (seit 1966) nach Studien mit gutem Design und entsprechender Größe und Aussagekraft mit folgenden Suchbegriffen durchgeführt: "breast cancer, chemotherapy, surgery, radiotherapy". ERGEBNISSE: Die Früherkennung von Mammakarzinom während der Schwangerschaft benötigt einen pro-aktiven Zugang, vor allem bei Mutationen der BRCA-Gene und älteren Frauen mit Kinderwunsch. Abhängig von Trimester inkludiert das Management Chirurgie und Chemotherapie, während adjuvante Therapie nach der Entbindung erfolgt. Obwohl sich die Koinzidenz erst in einem späteren Krankheitsstadium darstellt, scheint für eine schlechte Prognose nicht die Schwangerschaft selbst, sondern eine mangelhaft definierte postpartale Phase verantwortlich zu sein. SCHLUSSFOLGERUNGEN: Bei entsprechendem Risikoprofil sollte bei Kinderwunsch die Möglichkeit eines Mammakarzinoms während der Schwangerschaft ausgeschlossen werden.

Summary

BACKGROUND: Patients with concurrent pregnancy and breast cancer are likely to increase owing to the increase in the maternal age at first full-term pregnancy. Such concurrence is more likely in mutation carriers of BRCA1 and possibly BRCA2 in whom the risk of occurrence of breast cancer at relatively younger age favors the concurrence. The incidence of breast cancer during pregnancy varies from 0.2 to 3.8%. METHODS: All material for the review was obtained from the PubMed search using key words pregnancy, breast cancer, chemotherapy, surgery, and radiotherapy. The period from 1966 – present was used. References of obtained articles were used for retrieving more material. Adequately designed, good-size English articles were preferred for this review. RESULTS AND CONCLUSIONS: A proactive approach is needed to identify cases of breast cancer in pregnancy particularly in mutation carriers of BRCA genes and those who get pregnant for the first time at an advanced age in order to minimize the delay in diagnosis. Standard therapeutic modalities, surgery, and chemotherapy are being used restrictively as regards the trimester of pregnancy and choice of chemotherapeutic agents while adjuvant radiotherapy is usually delayed till delivery. Though the coincidence only appears at a relatively late stage of the disease, a poorly defined post pregnancy period but not the pregnancy itself, as an isolated variable, seems to be related to the poor prognosis.

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  1. Department of General Surgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

    M. Wani, T. A. Dass, Z. Naikoo, F. Parray & N. Wani

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  1. M. Wani
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Wani, M., Dass, T., Naikoo, Z. et al. Breast cancer in pregnancy. Eur Surg 43, 120–125 (2011). https://doi.org/10.1007/s10353-011-0595-9

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