Metastatic breast cancer in pregnancy: first case of chemotherapy with docetaxel

The focus of this paper is a case study of a woman in the first trimester o f pregnancy who presented with metastatic breast cancer. The bony spread of the metastases was rapid and it was necessary to treat the patient as soon as possible after the period of organogenesis (days 18-60 of human gestati on). This stage is the phase of greatest sensitivity of teratogens and the malformations are observed most often. Yet, the choice of third-line chemot herapy was difficult because of anthracycline-resistant metastatic breast c ancer. The world literature reported cytotoxic combinated regimens as the s tandard of care for the management of the metastases. The development of ne w antitumoral strategies with less toxicity and their encouraging results l ed us to the approval of docetaxel for the treatment of the patient even th ough it had never been tested in pregnancy. Docetaxel is a potent inhibitor of microtubule depolymerization and has a unique ability to alter certain classes of microtubules. The monochemotherapy was administered once every 3 weeks for a total of three cycles until 30 weeks of gestation. During the 32nd week of pregnancy the patient delivered a female infant whose birthwei ght and Apgar score were normal. The infant did not have any anomalies. The woman finished her treatment in puerperium and she received three cycles o f docetaxel. The patient has been receiving vinorelbine (one cycle every 2 weeks) for 2 years; her last follow-up was good and showed that the progres sion of the metastases had stopped. The daughter's psychophysical developme nt was normal.