Exploring the safety of chemotherapy for treating breast cancer during pregnancy

Abstract

Introduction: 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.

Areas covered: The aim of this article is to review the available evidence on the safety of chemotherapy administration in managing BCP.

Expert opinion: 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.

Keywords:

• anthracycline
• breast cancer during pregnancy
• chemotherapy
• fetal and child monitoring
• taxanes

Declaration of interest

M Lambertini has been supported by an ESMO Clinical Unit Visit grant. HA Azim Jr is consultant and received honoraria from GlaxoSmithKline and Novartis. The other authors declare no conflict of interest. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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