Other Considerations for Pregnancy and Breast Cancer
Lactation
Fetal Consequences of Maternal Breast Cancer
Consequences of Pregnancy in Patients with a History of Breast Cancer
Lactation
Suppression of lactation does not improve prognosis. If surgery is
planned, however, lactation should be suppressed to decrease the size and vascularity of
the breasts. If chemotherapy is to be given, lactation should also be suppressed because many antineoplastics (specifically cyclophosphamide and methotrexate), when
given systemically, may occur in high levels in breast milk and would
affect the nursing baby. In general, women receiving chemotherapy should not
breastfeed.
Fetal Consequences of Maternal Breast Cancer
No damaging effects on the fetus from maternal breast cancer have been
demonstrated, and there are no reported cases of maternal-fetal transfer of
breast cancer cells.
Consequences of Pregnancy in Patients with a History of Breast Cancer
Pregnancy does not appear to compromise the survival of women with a previous
history of breast cancer, based on limited retrospective data, and no
deleterious effects have been demonstrated in the fetus.[1-9] Some
physicians recommend that patients wait 2 years after diagnoses before
attempting to conceive. This allows early recurrence to become manifest, which
may influence the decision to become a parent. Little is known about pregnancy
after bone marrow transplantation and high-dose chemotherapy with or without
total-body irradiation. In one report of pregnancies after bone marrow
transplantation for hematologic disorders, a 25% incidence of preterm labor and low
birth weight for gestational-age infants was noted.[10]
References
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Clark RM, Chua T: Breast cancer and pregnancy: the ultimate challenge. Clin Oncol (R Coll Radiol) 1 (1): 11-8, 1989.
[PUBMED Abstract]
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Harvey JC, Rosen PP, Ashikari R, et al.: The effect of pregnancy on the prognosis of carcinoma of the breast following radical mastectomy. Surg Gynecol Obstet 153 (5): 723-5, 1981.
[PUBMED Abstract]
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Petrek JA: Pregnancy safety after breast cancer. Cancer 74 (1 Suppl): 528-31, 1994.
[PUBMED Abstract]
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von Schoultz E, Johansson H, Wilking N, et al.: Influence of prior and subsequent pregnancy on breast cancer prognosis. J Clin Oncol 13 (2): 430-4, 1995.
[PUBMED Abstract]
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Kroman N, Mouridsen HT: Prognostic influence of pregnancy before, around, and after diagnosis of breast cancer. Breast 12 (6): 516-21, 2003.
[PUBMED Abstract]
-
Malamos NA, Stathopoulos GP, Keramopoulos A, et al.: Pregnancy and offspring after the appearance of breast cancer. Oncology 53 (6): 471-5, 1996 Nov-Dec.
[PUBMED Abstract]
-
Gelber S, Coates AS, Goldhirsch A, et al.: Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer. J Clin Oncol 19 (6): 1671-5, 2001.
[PUBMED Abstract]
-
Gwyn K, Theriault R: Breast cancer during pregnancy. Oncology (Huntingt) 15 (1): 39-46; discussion 46, 49-51, 2001.
[PUBMED Abstract]
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Rugo HS: Management of breast cancer diagnosed during pregnancy. Curr Treat Options Oncol 4 (2): 165-73, 2003.
[PUBMED Abstract]
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Sanders JE, Hawley J, Levy W, et al.: Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation. Blood 87 (7): 3045-52, 1996.
[PUBMED Abstract]
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