Choosing the appropriate pharmacotherapy for breast cancer during pregnancy: what needs to be considered?
Diletta FaveroLaura Sabina LapucheskyFrancesca PoggioSimone NardinMarta PerachinoLuca AreccoGraziana ScavoneSilvia OttonelloMaria Maddalena LatoccaRoberto BoreaSilvia PuglisiMaurizio CossoAlessandra FozzaStefano SpinaciMatteo LambertiniPublished in: Expert opinion on pharmacotherapy (2024)
Multidisciplinary care is key for a proper diagnostic-therapeutic management of breast cancer during pregnancy. Engaging patients and their caregivers in the decision-making process is essential and psychological support should be provided. The treatment of patients with breast cancer during pregnancy should follow the same recommendations as those for breast cancer in young women outside pregnancy but taking into account the gestational age at the time of treatment.Anthracycline-, cyclophosphamide-, and taxane-based regimens can be safely administered during the second and third trimesters with standard protocols, preferring weekly regimens whenever possible. Endocrine therapy, immune checkpoint inhibitors, and targeted agents are contraindicated throughout pregnancy, also due to the very limited data available to guide their administration in this setting. During treatment, careful fetal growth monitoring is mandatory, and even after delivery proper health monitoring for the children exposed in utero to chemotherapy should be continued.
Keyphrases
- electronic health record
- preterm birth
- gestational age
- healthcare
- end stage renal disease
- palliative care
- decision making
- public health
- ejection fraction
- newly diagnosed
- chronic kidney disease
- birth weight
- mental health
- peritoneal dialysis
- pregnancy outcomes
- quality improvement
- combination therapy
- patient reported outcomes
- machine learning
- radiation therapy
- replacement therapy
- pregnant women
- drug delivery
- risk assessment
- pain management
- sleep quality
- cell therapy
- health information
- health insurance
- affordable care act