Chemotherapy
for Breast Cancer During Second and Third Trimesters of Pregnancy
Appears Safe
According to results presented at the 40th annual meeting
of the American Society of Clinical Oncology (ASCO), chemotherapy
during the second and third trimesters of pregnancy in women
diagnosed with breast cancer does not appear to harm the fetus.
Being diagnosed with breast cancer during pregnancy is uncommon.
Due to its uncommon occurrence, data involving treatment with
chemotherapy during pregnancy is relatively scarce and researchers
continue to slowly build on existing data regarding this issue.
The biggest fear of receiving chemotherapy during pregnancy
is harm or even death to the fetus. Furthermore, postponing
treatment of a pregnant woman raises the risk that the cancer
will become more advanced and ultimately more likely to result
in a poorer prognosis. However, research continues to indicate
that some chemotherapy regimens administered in the second
and third trimesters may pose no threat to the growing fetus,
while optimizing long-term outcomes for the mother.
Researchers from England recently reviewed records from 28
women who were diagnosed with breast cancer during their pregnancy.
All women were treated with chemotherapy during their second
and third trimesters (except one who was treated during her
first trimester). Chemotherapy consisted of anthracycline-based
regimens (doxorubicin or epirubicin) or consisted of the regimen
referred to as CMF (cyclophosphamide, methotrexate, 5-fluorouracil).
Women received chemotherapy either prior to surgery or following
surgery. Seventeen patients underwent surgery during their
pregnancy, while some patients underwent surgery following
delivery. The majority of women had stages II and III breast
cancer, and the average number of chemotherapy cycles delivered
was 4. Of the 27 patients who received chemotherapy during
their second and third trimesters, no birth defects occurred.
The one patient who received chemotherapy during her first
trimester suffered a spontaneous abortion (miscarriage). The
average weight of the babies was over 6 pounds and the average
delivery occurred on the 37th week of pregnancy.
The researchers concluded that even though this was a small
group of women, these results add to a growing body of evidence
that chemotherapy delivered during the second and third trimester
of pregnancy does not appear to harm the fetus. Other results
have indicated, however, that chemotherapy administered during
the first trimester of pregnancy may pose significant risks
to the fetus. Women who are diagnosed with breast cancer during
pregnancy should discuss their individual risks and benefits
of treatment including chemotherapy with their healthcare
provider.
Reference:Ring A, Ellis P, Jones A, et al. Chemotherapy for
breast cancer given during pregnancy: A case series. Proceedings
from the 40th annual meeting of the American Society of Clinical
Oncology. 2004. Abstract No: 715.
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