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Invasive Ductal Carcinoma Of Breast Diagnosed In Pregnancy: Case Report

Year 2015, Volume: 12 Issue: 5, 200 - 202, 01.09.2015

Abstract

It is hard to diagnose and treat the pathologies of breast during pregnancy and lactation because of the physiological changes occurred in this period. In this case report we present an invasive ductal carcinoma case which was diagnosed during pregnancy.33 years old and 10 weeks pregnant woman G2, P1 , applied to our clinic with breast tenderness, pain and swelling in armpit and brown discharge from nipple soccasionaly. Symptoms were started in her eighth week of pregnancy. It was diagnosed as invasive ductal carcinoma by a fine needle aspiration biopsy from left breast mass at 3 hour o’clock location. Neoadjuvan chemotherapy 4 cure FAC protocol: cyclophosphamid, adriamycin, 5-fulourouracil was given to patient at her 22nd weeks of pregnancy. 3 weeks after the last chemotherapy dose, in the 37th week of pregnancy, 2 780 gm. male baby was born via C/S with the diagnosis of breech presentation and previous C/S.Detailed ultrasonographic examination of fetus must take place in the middle of second trimestr because of teratogenic effects of cancer chemotherapy. The chemotherapy is usually applied in second trimester to prevent the risk of abortion. The birth timing must be determined according to perinatal status of fetus and maternal requirement of therapy.

References

  • Meydan N, Barutça S, Özgün H, Taşkın F, Yüksel H, Boylu Ş. Recurrent Medullary Breast Cancer After twin Conception. The Journal of Breast Healt. 2006; 2:31-3.
  • Üstün C, Özen N, Koçak İ, Kamalı A. Pregnancy and Breast Cancer.Ondo- kuz Mayıs Universty Medicine Faculty Journal. 1998;15:357-61.
  • Psyrri A, Burtness B. Pregnancy-Associated Brest Cancer. Review. The Cancer Journal 2005;11:83-95.
  • Kulshrestha M. Pregnancy-associated breast cancer. J S Asian Fed Obs- tet Gynecol 2011; 3:1-5.
  • Atalay C. Meme kanserinde nadir görülen durumlar. In: Aydın S, Akca T, editors. Tüm yönleriyle meme kanseri. Adana: Nobel Kitapevi, 2011:505- 510.
  • Donegan WL Brest carcinoma and pregnancy. In: Cancer of Breast, Do- negan WL and Spratt JS (Eds) Fourthed.WB Sounder. Philadelphia, pp: 732-741, 1995.
  • Gelber S, Coates AS, Goldhirsch A, Castiglione-Gertsch M, Marini G, Lindtner J, Edelmann DZ, Gudgeon A, Harvey V, Gelber RD; International Breast Cancer Study Group. Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer. J Clin Oncol. 2001:15;1671- 1675.
  • Loibl S, vonMinckwitz G, Gwyn K, Ellis P, Blohmer JU, Schlegelberger B, Keller M, Harder S, Theriault RL, Crivellari D, Klingebiel T, Louwen F, Kaufmann M: Breast carcinoma during pregnancy. International recom- mendations from an expert meeting. Cancer 2006;106:237–246.
  • Rovera F, Frattini F, Coglitore A, Marelli M, Rausei S, Dionigi G, Boni L
  • Dionigi R. Breast cancer in pregnancy. The Breast Journal 2010; 16:22- 25
  • Lenhard MS, Bauerfeind I, Untch M. Breast cancer and pregnancy: chal- lenges of chemotherapy. Crit Rev Oncol Hematol 2008; 67:196-203.
  • Ayyappan AP, Sulkarni S, Crystal P. Pregnancy-associated breast cancer
  • spectrum of imaging appearances. Br J Radiol 2010; 83:529-534.
  • Hogge JP, De Paredes ES, Magnant CM, Lage J. Imaging and Mana- gement of Breast Masses During Pregnancy and Lactation. Breast J. 1999;5: 272-283
  • Gemignani ML, Petrek JA. Pregnancy After Breast Cancer. Cancer Cont- rol. 1999;6: 272-276.
  • Gemignani ML, Petrek JA. Pregnancy-Associated Breast Cancer: Diag- nosis and Treatment. Breast J. 2000;6: 68-73.
  • Reed W, Hannisdal E, Skovlund E, Thoresen S, Lilleng P, Nesland JM. Pregnancy and breast cancer: a population-based study. Virchows Arch 2003; 443:44-50.
  • Eedarapallı P, Jain S. Breast cancer in pregnancy. J Obstet Gynaecol 26:1- 4.
  • Keleher AJ, Theriault RL, Gwyn KM, Hunt KK, Stelling CB, Singletary SE
  • Ames FC, Buchholz TA, Sahin AA, Kuerer HM. Multidisciplinary manage- ment of breast cancer concurrent with pregnancy. J Am Coll Surg 2002; 194:54-64.
  • Melnick DM. Wahl WL, Dalton VK. Management of general surgical prob- lems in the pregnant patient. Am J Surg 2004; 187:170-180.
  • American Cancer Society. Pregnancy and breast cancer. (cited 2012
  • November 1) Avaliablefrom: URL: http://www.cancer.org/cancer/breast- cancer/
  • Kuerer HM, Gwyn K, Ames FC, The riault RL.Conservative surgery and chemotherapy for breast carcinoma during pregnancy. Surgery. 2002;131:108-110.
  • Azim HA Jr, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, tar- geted agents and immuno therapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev 2010;36:101-9.
  • Loibl S, von Minckwitz G, Gwyn K, et al. Breast carcinoma during preg- nancy. International recommendations from an expert meeting. Cancer 2006;106:237-46.
  • Pentheroudakis G, Orecchia R, Hoekstra HJ, et al. Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21: 266-73.
  • NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 2.2012. Available online: http://www.nccn.com
  • Buhimschi CS, Weiner CP. Medications in pregnancy and lactation. Obs- tet Gynecol. 2009;113:166-188.
  • Behrman RH, Homer MJ, Yang WT, et al. Mammography and fetal dose. Radiology 2007;243:605-6.
  • Martin DD. Review of radiation therapy in the pregnant cancer patient. Clin Obstet Gynecol 2011;54:591-601.
  • Avilés A, Neri N. Hematological malign ancies and pregnancy: a final re- port of 84 children who received chemotherapy in utero. Clin Lymphoma. 2001;2: 173-17.

Gebelikte Tanısı Konulan Memenin İnvaziv Duktal Karsinomu: Olgu Sunumu

Year 2015, Volume: 12 Issue: 5, 200 - 202, 01.09.2015

Abstract

Gebelikte meme patolojilerinin tanısı ve tedavisi zordur. Bu olgu sunumunda gebelikte tanı alan invazif duktal kanser olgusu sunulmuştur. 33 yaşında kadın hasta G2P1Y1, yaklaşık gebeliğinin 8.haftasından itibaren memelerde hassasiyet, koltuk altında şişlik ve ağrı, ara ara meme başından kahve renkli akıntı şikayeti olması nedeniyle polikliniğimize başvurdu. Sol memede saat 3 lokalizasyonundaki kitleden yapılan ince iğne aspirasyon biopsisi sonucu invazif duktal karsinom ile uyumlu saptandı. Hastaya neoadjuvan kemoterapi 4 kür siklofosfamid- adriamisin- 5-Florourasil, FAC protokolü verildi. Son kemoterapi dozundan 3 hafta sonra 37.gebelik haftasında ağrılı eski sezaryen makat geliş tanıları ile C/S abdominal ile 2780 gr canlı erkek bebek doğurtuldu.Kanser kemoterapisi alan hastalarda 2. ve 3. trimesterde fetusun detaylı ultrason taraması yapılmalıdır. Abortus riskini önlemek için kemoterapi 2. trimesterde uygulanmalıdır. Doğum zamanlaması fetus ve annenin durumuna göre ayarlanmalıdır.

References

  • Meydan N, Barutça S, Özgün H, Taşkın F, Yüksel H, Boylu Ş. Recurrent Medullary Breast Cancer After twin Conception. The Journal of Breast Healt. 2006; 2:31-3.
  • Üstün C, Özen N, Koçak İ, Kamalı A. Pregnancy and Breast Cancer.Ondo- kuz Mayıs Universty Medicine Faculty Journal. 1998;15:357-61.
  • Psyrri A, Burtness B. Pregnancy-Associated Brest Cancer. Review. The Cancer Journal 2005;11:83-95.
  • Kulshrestha M. Pregnancy-associated breast cancer. J S Asian Fed Obs- tet Gynecol 2011; 3:1-5.
  • Atalay C. Meme kanserinde nadir görülen durumlar. In: Aydın S, Akca T, editors. Tüm yönleriyle meme kanseri. Adana: Nobel Kitapevi, 2011:505- 510.
  • Donegan WL Brest carcinoma and pregnancy. In: Cancer of Breast, Do- negan WL and Spratt JS (Eds) Fourthed.WB Sounder. Philadelphia, pp: 732-741, 1995.
  • Gelber S, Coates AS, Goldhirsch A, Castiglione-Gertsch M, Marini G, Lindtner J, Edelmann DZ, Gudgeon A, Harvey V, Gelber RD; International Breast Cancer Study Group. Effect of pregnancy on overall survival after the diagnosis of early-stage breast cancer. J Clin Oncol. 2001:15;1671- 1675.
  • Loibl S, vonMinckwitz G, Gwyn K, Ellis P, Blohmer JU, Schlegelberger B, Keller M, Harder S, Theriault RL, Crivellari D, Klingebiel T, Louwen F, Kaufmann M: Breast carcinoma during pregnancy. International recom- mendations from an expert meeting. Cancer 2006;106:237–246.
  • Rovera F, Frattini F, Coglitore A, Marelli M, Rausei S, Dionigi G, Boni L
  • Dionigi R. Breast cancer in pregnancy. The Breast Journal 2010; 16:22- 25
  • Lenhard MS, Bauerfeind I, Untch M. Breast cancer and pregnancy: chal- lenges of chemotherapy. Crit Rev Oncol Hematol 2008; 67:196-203.
  • Ayyappan AP, Sulkarni S, Crystal P. Pregnancy-associated breast cancer
  • spectrum of imaging appearances. Br J Radiol 2010; 83:529-534.
  • Hogge JP, De Paredes ES, Magnant CM, Lage J. Imaging and Mana- gement of Breast Masses During Pregnancy and Lactation. Breast J. 1999;5: 272-283
  • Gemignani ML, Petrek JA. Pregnancy After Breast Cancer. Cancer Cont- rol. 1999;6: 272-276.
  • Gemignani ML, Petrek JA. Pregnancy-Associated Breast Cancer: Diag- nosis and Treatment. Breast J. 2000;6: 68-73.
  • Reed W, Hannisdal E, Skovlund E, Thoresen S, Lilleng P, Nesland JM. Pregnancy and breast cancer: a population-based study. Virchows Arch 2003; 443:44-50.
  • Eedarapallı P, Jain S. Breast cancer in pregnancy. J Obstet Gynaecol 26:1- 4.
  • Keleher AJ, Theriault RL, Gwyn KM, Hunt KK, Stelling CB, Singletary SE
  • Ames FC, Buchholz TA, Sahin AA, Kuerer HM. Multidisciplinary manage- ment of breast cancer concurrent with pregnancy. J Am Coll Surg 2002; 194:54-64.
  • Melnick DM. Wahl WL, Dalton VK. Management of general surgical prob- lems in the pregnant patient. Am J Surg 2004; 187:170-180.
  • American Cancer Society. Pregnancy and breast cancer. (cited 2012
  • November 1) Avaliablefrom: URL: http://www.cancer.org/cancer/breast- cancer/
  • Kuerer HM, Gwyn K, Ames FC, The riault RL.Conservative surgery and chemotherapy for breast carcinoma during pregnancy. Surgery. 2002;131:108-110.
  • Azim HA Jr, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, tar- geted agents and immuno therapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev 2010;36:101-9.
  • Loibl S, von Minckwitz G, Gwyn K, et al. Breast carcinoma during preg- nancy. International recommendations from an expert meeting. Cancer 2006;106:237-46.
  • Pentheroudakis G, Orecchia R, Hoekstra HJ, et al. Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21: 266-73.
  • NCCN Clinical Practice Guidelines in Oncology. Breast Cancer. Version 2.2012. Available online: http://www.nccn.com
  • Buhimschi CS, Weiner CP. Medications in pregnancy and lactation. Obs- tet Gynecol. 2009;113:166-188.
  • Behrman RH, Homer MJ, Yang WT, et al. Mammography and fetal dose. Radiology 2007;243:605-6.
  • Martin DD. Review of radiation therapy in the pregnant cancer patient. Clin Obstet Gynecol 2011;54:591-601.
  • Avilés A, Neri N. Hematological malign ancies and pregnancy: a final re- port of 84 children who received chemotherapy in utero. Clin Lymphoma. 2001;2: 173-17.
There are 32 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Özlem Şimşek Tanın This is me

Emel Kıyak Çağlayan This is me

Nagihan Sarı This is me

Levent Seçkin This is me

Mustafa Kara This is me

Kasım Çağlayan This is me

Yaprak Engin Üstün This is me

Publication Date September 1, 2015
Published in Issue Year 2015 Volume: 12 Issue: 5

Cite

Vancouver Şimşek Tanın Ö, Çağlayan EK, Sarı N, Seçkin L, Kara M, Çağlayan K, Engin Üstün Y. Gebelikte Tanısı Konulan Memenin İnvaziv Duktal Karsinomu: Olgu Sunumu. JGON. 2015;12(5):200-2.