BACKGROUND. During pregnancy, the need for maternal chemotherapy for breast
carcinoma must be balanced against the fetal risk because modification of
cancer therapy to assure the birth of a healthy infant may affect maternal
prognosis adversely. To the authors' knowledge few studies have documented
the oncologic and obstetric management of this association.
METHODS. A retrospective nationwide survey was used to identify women treat
ed with chemotherapy for breast carcinoma during pregnancy. Each member of
the Societe Francaise d'Oncologie Gynecologique and the Societe Francaise d
e Senologie et de Pathologie Mammaire completed a postal questionnaire rega
rding cancer staging, oncologic treatment, obstetric details, pregnancy out
come, fetal behavior, and postdelivery follow-up. Twenty women were accrued
to the study.
RESULTS. The mean gestational age at the first cycle of treatment was 26 we
eks. A total of 38 cycles were administered during pregnancy, with a median
of 2 cycles. Delivery was performed at a mean of 34.7 weeks. Two pregnanci
es that were exposed to chemotherapy during the first trimester resulted in
spontaneous abortion. One pregnancy exposed in the second trimester result
ed in intrauterine death. The remaining 17 pregnancies resulted in live bir
ths, although 3 women had complications related to chemotherapy (anemia, le
ukopenia, and fetal growth retardation) and 1 newborn died 8 days after bir
th without apparent etiology. Two newborns had complications related to pre
maturity (transient respiratory distress). At a mean follow-up of 42.3 mont
hs, all live infants were reported to have reached normal developmental mil
estones.
CONCLUSIONS. The current study found that even when chemotherapy was initia
ted after the first trimester, 95% of the pregnancies resulted in live birt
hs with low related morbidity in the newborns. (C) 1999 American Cancer Soc
iety.