Table 6
Open in new tab

Key points and contraindications for breast cancer treatment during pregnancy

Key points
1. Ultrasonography is the first‐line imaging modality. If concerning mass identified, bilateral mammography with appropriate shielding is recommended.
2. Surgery can be safely performed at any time during pregnancy, but second trimester is preferred. Lumpectomy and mastectomy are both reasonable surgical approaches.
3. The recommended method of lymphoscintigraphy is with 99m‐Tc sulfur colloid alone.
4. Chemotherapy should not be administered in the first trimester of pregnancy; anthracycline‐based chemotherapy can be safely initiated in the second and third trimesters of pregnancy.
5. Chemotherapy should be stopped approximately 3–4 wk before delivery to avoid hematologic nadir during delivery that may result in infectious or bleeding complications.
6. Dosing of chemotherapy in pregnant patient should be similar to that in nonpregnant patient (i.e., based on actual body surface area).
Contraindications
1. Gadolinium‐based contrast for MRI is not recommended.
2. Isosulfan blue dye is contraindicated for lymphoscintigraphy as dual tracer for sentinel lymph node biopsy.
3. Chemotherapy is contraindicated in first trimester of pregnancy and during lactation.
4. Endocrine treatment is contraindicated during pregnancy and lactation.
5. Anti‐HER2 therapy is contraindicated in pregnancy and lactation.
6. Radiation therapy is contraindicated during pregnancy and cautioned during lactation.
Key points
1. Ultrasonography is the first‐line imaging modality. If concerning mass identified, bilateral mammography with appropriate shielding is recommended.
2. Surgery can be safely performed at any time during pregnancy, but second trimester is preferred. Lumpectomy and mastectomy are both reasonable surgical approaches.
3. The recommended method of lymphoscintigraphy is with 99m‐Tc sulfur colloid alone.
4. Chemotherapy should not be administered in the first trimester of pregnancy; anthracycline‐based chemotherapy can be safely initiated in the second and third trimesters of pregnancy.
5. Chemotherapy should be stopped approximately 3–4 wk before delivery to avoid hematologic nadir during delivery that may result in infectious or bleeding complications.
6. Dosing of chemotherapy in pregnant patient should be similar to that in nonpregnant patient (i.e., based on actual body surface area).
Contraindications
1. Gadolinium‐based contrast for MRI is not recommended.
2. Isosulfan blue dye is contraindicated for lymphoscintigraphy as dual tracer for sentinel lymph node biopsy.
3. Chemotherapy is contraindicated in first trimester of pregnancy and during lactation.
4. Endocrine treatment is contraindicated during pregnancy and lactation.
5. Anti‐HER2 therapy is contraindicated in pregnancy and lactation.
6. Radiation therapy is contraindicated during pregnancy and cautioned during lactation.

Abbreviations: HER2, human epidermal growth factor receptor 2; MRI, magnetic resonance imaging.

Table 6
Open in new tab

Key points and contraindications for breast cancer treatment during pregnancy

Key points
1. Ultrasonography is the first‐line imaging modality. If concerning mass identified, bilateral mammography with appropriate shielding is recommended.
2. Surgery can be safely performed at any time during pregnancy, but second trimester is preferred. Lumpectomy and mastectomy are both reasonable surgical approaches.
3. The recommended method of lymphoscintigraphy is with 99m‐Tc sulfur colloid alone.
4. Chemotherapy should not be administered in the first trimester of pregnancy; anthracycline‐based chemotherapy can be safely initiated in the second and third trimesters of pregnancy.
5. Chemotherapy should be stopped approximately 3–4 wk before delivery to avoid hematologic nadir during delivery that may result in infectious or bleeding complications.
6. Dosing of chemotherapy in pregnant patient should be similar to that in nonpregnant patient (i.e., based on actual body surface area).
Contraindications
1. Gadolinium‐based contrast for MRI is not recommended.
2. Isosulfan blue dye is contraindicated for lymphoscintigraphy as dual tracer for sentinel lymph node biopsy.
3. Chemotherapy is contraindicated in first trimester of pregnancy and during lactation.
4. Endocrine treatment is contraindicated during pregnancy and lactation.
5. Anti‐HER2 therapy is contraindicated in pregnancy and lactation.
6. Radiation therapy is contraindicated during pregnancy and cautioned during lactation.
Key points
1. Ultrasonography is the first‐line imaging modality. If concerning mass identified, bilateral mammography with appropriate shielding is recommended.
2. Surgery can be safely performed at any time during pregnancy, but second trimester is preferred. Lumpectomy and mastectomy are both reasonable surgical approaches.
3. The recommended method of lymphoscintigraphy is with 99m‐Tc sulfur colloid alone.
4. Chemotherapy should not be administered in the first trimester of pregnancy; anthracycline‐based chemotherapy can be safely initiated in the second and third trimesters of pregnancy.
5. Chemotherapy should be stopped approximately 3–4 wk before delivery to avoid hematologic nadir during delivery that may result in infectious or bleeding complications.
6. Dosing of chemotherapy in pregnant patient should be similar to that in nonpregnant patient (i.e., based on actual body surface area).
Contraindications
1. Gadolinium‐based contrast for MRI is not recommended.
2. Isosulfan blue dye is contraindicated for lymphoscintigraphy as dual tracer for sentinel lymph node biopsy.
3. Chemotherapy is contraindicated in first trimester of pregnancy and during lactation.
4. Endocrine treatment is contraindicated during pregnancy and lactation.
5. Anti‐HER2 therapy is contraindicated in pregnancy and lactation.
6. Radiation therapy is contraindicated during pregnancy and cautioned during lactation.

Abbreviations: HER2, human epidermal growth factor receptor 2; MRI, magnetic resonance imaging.

Close
This Feature Is Available To Subscribers Only

Sign In or Create an Account

Close

This PDF is available to Subscribers Only

View Article Abstract & Purchase Options

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Close