From the Guidelines
Pregnant patients can receive breast conservation therapy (BCT) for breast cancer, but the timing of radiation therapy is crucial and must be delayed until after delivery. BCT typically involves lumpectomy surgery to remove the tumor while preserving the breast, followed by radiation therapy. Surgery is generally considered safe during any trimester of pregnancy, with minimal risk to the developing fetus, as stated in the guidelines by 1 and 1. However, radiation therapy, which is an essential component of BCT, poses significant risks to the fetus and must be delayed until after delivery.
Key Considerations
- The decision to pursue BCT during pregnancy should involve a multidisciplinary team including surgical oncologists, radiation oncologists, maternal-fetal medicine specialists, and medical oncologists to ensure optimal care for both mother and baby, as suggested by 1.
- The stage of cancer, gestational age at diagnosis, and patient preferences all factor into treatment planning, as outlined in the guidelines by 1.
- Chemotherapy, if needed, can usually be safely administered during the second and third trimesters, as indicated by 1.
- Outcomes for pregnant women who receive appropriate breast cancer treatment are generally comparable to non-pregnant women with similar disease characteristics, as noted in the study by 1.
Treatment Approach
- In the first trimester, breast-conserving treatment (BCT) is not a treatment option due to the need for adjuvant radiotherapy, which would be delayed until post-partum, as stated in the guidelines by 1.
- In the second and third trimesters, the surgical approach applied should not differ significantly from that applied to non-pregnant women, and BCT or mastectomy with axillary lymph node dissection (ALND) can be considered, as suggested by 1.
- The use of sentinel lymph node biopsy (SLNB) can be considered in pregnant breast cancer patients, but more data are needed to fully assess its safety and accuracy in this setting, as noted in the study by 1.
From the Research
Breast Conservation Therapy for Pregnant Patients
- There is no direct evidence in the provided studies that specifically addresses whether pregnant patients can get breast conservation therapy.
- However, the studies discuss the effectiveness and safety of breast conservation therapy for early-stage breast cancer in general, which may be relevant for pregnant patients with breast cancer.
- According to 2, breast conservation is a safe and effective alternative to mastectomy for the majority of women with early-stage breast cancer.
- The studies 3, 4, 5, 6 discuss the benefits and outcomes of breast conservation therapy compared to mastectomy, but do not specifically mention pregnant patients.
- It is essential to consult with a healthcare professional to determine the best course of treatment for pregnant patients with breast cancer, as the decision to undergo breast conservation therapy or mastectomy depends on various factors, including the stage and type of cancer, as well as the patient's overall health and preferences.