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سرطان پستان در طول بارداری

شکرچیان, سپهر and قزلباش, سيما (1392) سرطان پستان در طول بارداری. در: 9thInternational Breast Cancer Congress, 26-28 February 2014, Shahid Beheshti University of Medical Sciences,Tehran, Iran.

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Breast cancer during pregnancy

English Abstract

Background Breast cancer is one of the most common cancers during pregnancy with the frequency approaching one in 3000 pregnancies. Pregnancy-associated breast cancer is defined as breast cancer that occurs during pregnancy or within one year of delivery. Breast cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. A challenging situation emerges for all persons involved patient, family and medical care workers since two lives are at risk with contradicting priorities. Methods This study was a comprehensive literature review performed through searches in databases such as Medline, PubMed, Science Direct, Scopus, and Google Scholar using the terms " Breast Cancer, Pregnancy, Cancer treatment ". Findings As the breast changes with pregnancy, these changes pose some challenges to the diagnosis, monitoring and treatment of breast cancer. Often, a delay in cancer diagnosis in pregnant breast cancer patients is secondary to pregnancy and lactation, including increased size and density of the breast tissue. Thus, pregnant breast cancer patients often present with an advanced disease stage and with axillary lymph node involvement. Given the concern for a delayed diagnosis, palpable masses persisting over 2 weeks during pregnancy should be investigated, although it is reported that approximately 80% of breast biopsies during pregnancy will be benign. Breast cancer treatment is possible during pregnancy. The management of women who have breast cancers diagnosed whilst they are pregnant is challenging. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risks of harm to the fetus. The treatment plan needs to adhere as closely as possible to standardized protocols for nonpregnant patients, with some considerations to minimize fetal exposure and risks. This concerns mainly limiting radiation exposure and timing of chemotherapy to start in the second trimester. In total The goals of breast cancer treatment, such as local control of the disease and the prevention of systemic metastases, are the same in a pregnant woman as in a non-pregnant woman, but some modifications may be necessary to minimize fetal harm. Breast and chest wall irradiation for example are postponed until after delivery because of the risks of fetal exposure to radiation. The patients diagnosed during the second trimester usually received six courses of neoadjuvant chemotherapy type FEC (5-fluorouracil, epirubicin, cyclophosphamide) but locoregional radiotherapy and surgery were postponed until after delivery. According results of studies no congenital malformation, stillbirth or intrauterine growth restrictions were observed in fetuses whose mothers received chemotherapy during pregnancy. Conclusion The need for prompt therapy often presents a clinical dilemma of considerable magnitude as there is always a conflict between optimal maternal therapy and the resultant risks imposed on fetal well-being. Treatment options depend on the patient’s condition as well as on the gestational age at presentation. In a multidisciplinary approach, an optimal therapy schedule should be assessed depending on these conditions. It is the role of nurses to implement integral and multidisciplinary care for women experiencing breast cancer during pregnancy, intensifying continuous and individualized evaluation during prenatal care, acknowledging the participation of women and families in decision-making concerning the treatment and maintenance of pregnancy, and considering ethical, religious, psychological, organic and legal aspects.

Item Type:Conference or Workshop Item (Poster)
زبان سند : انگلیسی
نویسنده اول :سپهر شکرچیان
نویسنده مسئول :سيما قزلباش
کلیدواژه ها (انگلیسی):Breast Cancer, Pregnancy, Cancer treatment
Subjects:WP Gynecology
Divisions:Faculty of Nursing & Midwifery > Department of Nursing
ID Code:5455
Deposited By: MS Azam Ghorbani
Deposited On:18 Dec 1392 13:02
Last Modified:18 Dec 1392 13:02

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