Suggested surgical management of breast cancer during pregnancy based on trimester at presentation
| Trimester . | Surgical management . |
|---|---|
| First | 1. Chemotherapy not appropriate 2. Consider awaiting the second trimester to initiate therapy depending on disease severity and week of gestation 3. Consider surgery cautiously with RSI and FM |
| Second | 1. Consider neoadjuvant chemotherapy to downstage disease and allow for further workup 2. Consider surgery (using RSI and FM) followed by adjuvant chemotherapy |
| Third | 1. Chemotherapy not appropriate unless it can be halted approximately 3–4 wk before EDD; can resume after delivery or proceed with surgery after delivery 2. Consider surgery cautiously (using RSI, FM, and proper positioning) followed by adjuvant therapy after delivery 3. Consider awaiting or hastening delivery and treating in the postpartum period depending on disease severity and week of gestation/fetal maturity |
| Trimester . | Surgical management . |
|---|---|
| First | 1. Chemotherapy not appropriate 2. Consider awaiting the second trimester to initiate therapy depending on disease severity and week of gestation 3. Consider surgery cautiously with RSI and FM |
| Second | 1. Consider neoadjuvant chemotherapy to downstage disease and allow for further workup 2. Consider surgery (using RSI and FM) followed by adjuvant chemotherapy |
| Third | 1. Chemotherapy not appropriate unless it can be halted approximately 3–4 wk before EDD; can resume after delivery or proceed with surgery after delivery 2. Consider surgery cautiously (using RSI, FM, and proper positioning) followed by adjuvant therapy after delivery 3. Consider awaiting or hastening delivery and treating in the postpartum period depending on disease severity and week of gestation/fetal maturity |
Abbreviations: EDD, estimated due date; FM, fetal monitoring; RSI, rapid sequence induction.
Suggested surgical management of breast cancer during pregnancy based on trimester at presentation
| Trimester . | Surgical management . |
|---|---|
| First | 1. Chemotherapy not appropriate 2. Consider awaiting the second trimester to initiate therapy depending on disease severity and week of gestation 3. Consider surgery cautiously with RSI and FM |
| Second | 1. Consider neoadjuvant chemotherapy to downstage disease and allow for further workup 2. Consider surgery (using RSI and FM) followed by adjuvant chemotherapy |
| Third | 1. Chemotherapy not appropriate unless it can be halted approximately 3–4 wk before EDD; can resume after delivery or proceed with surgery after delivery 2. Consider surgery cautiously (using RSI, FM, and proper positioning) followed by adjuvant therapy after delivery 3. Consider awaiting or hastening delivery and treating in the postpartum period depending on disease severity and week of gestation/fetal maturity |
| Trimester . | Surgical management . |
|---|---|
| First | 1. Chemotherapy not appropriate 2. Consider awaiting the second trimester to initiate therapy depending on disease severity and week of gestation 3. Consider surgery cautiously with RSI and FM |
| Second | 1. Consider neoadjuvant chemotherapy to downstage disease and allow for further workup 2. Consider surgery (using RSI and FM) followed by adjuvant chemotherapy |
| Third | 1. Chemotherapy not appropriate unless it can be halted approximately 3–4 wk before EDD; can resume after delivery or proceed with surgery after delivery 2. Consider surgery cautiously (using RSI, FM, and proper positioning) followed by adjuvant therapy after delivery 3. Consider awaiting or hastening delivery and treating in the postpartum period depending on disease severity and week of gestation/fetal maturity |
Abbreviations: EDD, estimated due date; FM, fetal monitoring; RSI, rapid sequence induction.
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