Treatment of breast cancer during pregnancy: regimen selection, pregnancy monitoring and more.

Abstract

Breast cancer is uncommonly diagnosed during pregnancy but when encountered, it poses several clinical conflicts. Managing patients with gestational breast cancer should not be associated with considerable risk of morbidity provided the choice of the right drug in the right time for the right patient. Due to its relative rarity, we lack a standardized approach to manage these patients. Previous reports have suggested that women can be offered treatment strategies similar to those offered in the "non-pregnant" setup. Nevertheless, generalizing treatment decisions is too hard and treatment of these cases should be tailored according to the clinical situation. In order to ensure proper counseling of these patients, there are several key points that need to be addressed. These include timing of chemotherapy administration, the scheduling of agents, and pregnancy monitoring. In this review, we provide some guidance on how to select the chemotherapy regimen and address the feasibility and safety of administering trastuzumab during pregnancy. We also discuss some practical points on monitoring these patients during the course of pregnancy.