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Re: Pregnancy after breast cancerFrom: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk)Thu Nov 28 15:29:50 1996
In message <PEmoLDAEQ$myEwwQ@dial.pipex.com>, Dr Onnig Tamizian <abf48@dial.pipex.com> writes >Dear Listmembers, > >We had an interesting lady in Antenatal booking clinic yesterday. She is >a 32 year old schoolteacher in her first pregnancy booking at 17 weeks >gestation by dates and scan but was treated in 1993 for carcinoma of the >left breast with left subcutaneous mastectomy and breast implant >followed by 6 cycles of chemotherapy with Cyclophosphamide, 5 Fluouracil >and methotrexate. The tumour was poorly differentiated with vascular >space involvement but no lymph node spread but at present no further >histological details as treatment was carried out elsewhere. There has >been no evidence of any recurrence so far. > >Any thoughts on her management and any ideas/experience as to how the >pregnancy might affect the chances of recurrence? > I was particularly interested in the topic of malignanacy in pregnancy a few years ago. Two reasons I did a review of acute leukaemaias in pregnancy for my MRCOG case book ( ~ 1985/6 ). Around the same time I was involved with a case like yours. She had been advised she was clear of tumour. In the late second trimester she developed overt metastatic disease. A "hysterotomy" was performed at 26 weeks acknowledging that the fetus might not survive and that she might get better ( she was near comatose pre-op ! ). She initally got better. Baby was dodgy but survived. She never left the post-natal ward and died from carcinomatosis at 2 months he went home with his dad ( even remeber baby's name still - Benjamin ! ). Although seemingly dated I would recommend looking at a special issue of Seminars in Oncology ( 1989;16(5) ). For a review of cancers in pregancy. See pages 369 - 376 for Ca Breast. As far as the fetus is concerned metastsis to the fetus and placenta is very rare for canacers in general. Ca breast is one of those that *very* rarely metastasise to placenta but not to fetus.
--
Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt
Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK.
Tel: 01582-497459 (office)
01525-222849 (home)
Fax: 01582-497424
email: Malcolm@mgriff22.demon.co.uk
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