medigraphic.com

2013, Número 2

<< Anterior Siguiente >>

Cir Cir 2013; 81 (2)


Embarazo y cáncer de mama

Ramírez-Torres N, Asbun-Bojalil J, Hernández-Valencia M

Idioma: Español
Referencias bibliográficas: 46
Paginas: 98-107
Archivo PDF: 1053.43 Kb.


RESUMEN

Introducción: la asociación de cáncer de mama y embarazo no es común. El objetivo de esta investigación fue evaluar el embarazo, edad joven, etapa, tratamiento, pronóstico y mortalidad de las mujeres con cáncer de mama durante el embarazo.
Material y métodos: análisis retrospectivo de marzo 1992 a febrero 2009, se incluyeron 16 pacientes con cáncer de mama y embarazo. Se analizó: presentación clinicopatológica del tumor, tratamiento oncológico, evolución del embarazo. Del recién nacido se analizó: Apgar y peso. Se evaluo la mortalidad por grupo de edad y por intervalo de tiempo entre último embarazo y diagnóstico posterior de cáncer de mama y embarazo.
Resultados: características clínicohistológicas predominantes: etapa III (81.2%), T3-T4 (75%), N+ (93.7%), carcinoma ductal invasor (87.5%), grado histológico 2-3 (93.7%), receptor de estrogéno positivo (43.7%), receptor de progesterona positivo (25%), y receptor 2 del factor de crecimiento epidérmico humano positivo (31.2%).
Se aplicaron 27 ciclos de quimioterapia con: 5-fluorouracilo, epirrubicina y ciclofosfamida durante el segundo o tercer trimestre del embarazo, no hubo efectos adversos severos en las madres ni en los neonatos. El tiempo promedio de recurrencia de la enfermedad fue de 18.8 meses (limites 6-62 meses). La tasa de mortalidad en menores de 35 años fue 31.3% (p = 0.358). De las 16 pacientes, 7 habían muerto, y 9 estaban vivas sin evidencia de enfermedad.
Conclusiones: la etapa avanzada y número de ganglios afectados fueron más importantes que la edad, como los predictores de mal pronóstico para la recidiva y mortalidad de las pacientes jovenes con cáncer de mama y embarazo.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Ferlay J, Bray F, Pisani P. Globocan 2002: Cancer incidence, mortality and prevalence worwilde. Lyon: IARC Press;2004.

  2. Wallack MK, Wolf JA Jr, Bedwinek J, Denes AE, Glasgow G, Kumar B, et al. Gestational carcinoma of the female breast. Curr Probl Cancer 1983;7(9):1-58.

  3. Loibl S, von Minckwitz G, Gwyn K, Ellis P, Blohmer JU, Schlegelberger B, et al. Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer 2006;106(2):237-246.

  4. Andersson TML, Johansson ALV, Hsieh CC, Cnattingius S, Lambe M. Increasing incidence of Pregnancy-Associated Breast Cancer in Sweden. Obstet Gynecol 2009;114(3):568-572.

  5. Centers for Disease Control and Prevention. (consultado Agosto 2012). disonible en: [http://www.cdc.gov/nchs/products/vsus. htm]. Vital Statistics of the United States, 2002. Vol. I. Natality. Hyattsville, MD: National Center for Health Statistics; 2007.

  6. Stensheim H, Moller B, van Dijk T, Fossa SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009;27(1):45-51.

  7. de la Rochefordiere A, Campana F, Fenton J, Vilcoq JR, Fourquet A, Asselain B, et al. Age as prognostic factor in premenopausal breast carcinoma. Lancet 1993;341(8852):1039-1043.

  8. Anderson BO, Petrek JA, Byrd DR, Senie RT, Borgen PI. Pregnancy influences breast cancer stage at diagnosis in women 30 years of age and younger. Ann Surg Oncol 1996;3(2):204-211.

  9. Beadle BM, Woodward WA, Middleton LP, Tereffe W, Strom EA, Litton JK, et al. The impact of pregnancy on breast cancer outcomes in women < 35 years. Cancer 2009;115(6):1174-1184.

  10. Middleton LP, Amin M, Gwym K, Theriault R, Sahin A. Breast carcinoma in pregnant women. Assessment of clinicopathologic and inmunohistochemical features. Cancer 2003;98(5):1055-1060.

  11. Petrek JA, Dukoff R, Rogatko A. Prognosis of pregnancy-associated breast cancer. Cancer 1991;67(4):869-872.

  12. Romero JR, Hernández EF, Nava HMC. Carcinoma mamario y embarazo. Rev Mex Mastol 1992;1:7-17.

  13. León Villalba JC, López Graniel CM, Lara Medina F, Calderón GEd, Chanona-Vilchis G, Solorza Luna G. Cáncer y embarazo. Experiencia en el Instituto de Cancerología de México. Rev Inst Nal Cancerol Mex 1999;45(3):144-152.

  14. Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 1996;78(8):1838-1843.

  15. Bleyer A. Young Adult Oncology: The Patients and Their Survival Challenges. CA Cancer J Clin 2007;57(4):242-255.

  16. Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 2003;189(4):1128-1135.

  17. Antonelli NM, Dotters DJ, Katz VL, Kuller JA. Cancer in Pregnancy: A Review of the Literature. Part I. Obstet Gynecol Surv 1996;51(2):125-134.

  18. Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, et al. Young Age at Diagnosis Correlates With Worse Prognosis and Defines a Subset of Breast Cancers With Shared Patterns of Gene Expression. J Clin Oncol 2008;26(20):3324-3330.

  19. Carlson RW, Edge SB, Theriault RL, NCCN Breast Cancer Practice Guidelines Panel. NCCN: Breast Cancer. Cancer Control 2001;8(6 Suppl 2):54-61.

  20. Adami HO, Malker B, Holmberg L, Persson I, Stone B. The relation between survival and age at diagnosis and breast cancer. N Engl J Med 1986;315(9):559-563.

  21. Xiong Q, Valero V, Kau V, Kau SW, Taylor S, Smith TL, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis: The M.D. Anderson Cancer Center experience. Cancer 2001;92(10):2523-2528.

  22. Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY. Do young breast cancer patients have worse outcomes? J Surg Res 2003;113(1):109-113.

  23. Dowsett M, Archer C, Assersohn L, Gregory RK, Ellis PA, Salter J, et al. Clinical studies of apoptosis and proliferation in breast cancer. Endocr Relat Cancer 1999;6(1):25-28.

  24. Zemlickis D, Lishner M, Degendorfer P, Panzarella T, Burke B, Sutcliffe SB, et al. Maternal and fetal outcome after breast cancer in pregnancy. Am J Obstet Gynecol 1992;166(3):781-787.

  25. Ishida T, Yokoe T, Kasumi F, Sakamoto G, Makita M, Tominaga T, et al. Clinicopathologic Characteristics and Prognosis of Breast Cancer Patients Associated with Pregnancy and Lactation: Analysis of Case- Control Study in Japan. Jpn J Cancer Res 1992;83(11):1143-1149.

  26. Bonnier P, Romain S, Dilhuydy JM, Bonichon F, Julien JP, Charpin C, et al. Influence of pregnancy on the outcome of breast cancer: A case-control study. Int J Cancer 1997;72(5):720-727.

  27. Rodriguez AO, Chew H, Cress R, Xing G, McElvy S, Danielsen B, et al. Evidence of Poorer Survival in Pregnancy-Associated Breast Cancer. Obstet Gynecol 2008;112(1):71-78.

  28. Berry DL, Theriault RL, Holmes FA, Parisi VM, Booser DJ, Singletary SE, et al. Management of Breast Cancer During Pregnancy Using a Standarized Protocol. J Clin Oncol 1999;17(3):855-861.

  29. Ring AE, Smith IE, Jones A, Shannon C, Galani E, Ellis PA. Chemotherapy for Breast Cancer During Pregnancy: An 18-Year Experience From Five London Teaching Hospitals. J Clin Oncol 2005;23(18):4192-4197.

  30. Nettleton J, Long J, Kuban D, Wu R, Shaeffer J, El-Mahdi A. Breast cancer during pregnancy: quantifying the risk of treatment delay. Obstet Gynecol 1996;87(3):414-418.

  31. Shousha S. Breast Carcinoma Presenting During or Shortly After Pregnancy and Lactation. Arch Pathol Lab Med 2000;124(7):1053- 1060.

  32. Elledge RM, Ciocca DR, Langone G, McGuire WL. Estrogen receptor, progesterone receptor, and HER-2/neu protein in breast cancers from pregnant patients. Cancer 1993;71(8):2499-2506.

  33. Johannsson O, Loman N, Borg A, Olsson H. Pregnancy-associated breast cancer in BRCA1 and BRCA2 germline mutation carriers. Lancet 1998;352(9137):1359-1360.

  34. Daling JR, Malone KE, Voigt LF, White E, Weiss NS. Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion. J Natl Cancer Inst 1994;86(21):1584-1592.

  35. Tretli S, Kvalheim G, Thoresen S, HÃ, st H. Survival of breast cancer patients diagnosed during pregnancy or lactation. Br J Cancer 1988;58(3):382-384.

  36. Lippman ME, Dickson RB, Gelmann EP, Rosen N, Knabbe C, Bates S, et al. Growth regulation of human breast carcinoma occurs through regulated growth factor secretion. J Cell Biochem 1987;35(1):1-16.

  37. Russo J, Moral R, Balogh GA, Mailo D, Russo IH. The protective role of pregnancy in breast cancer. Breast Cancer Res 2005;7(3):131- 142.

  38. Schedin P. Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer 2006;6(4):281-291.

  39. Phillips KA, Milne RL, Friedlander ML, Jenkins MA, McCredie MRE, Giles GG, et al. Prognosis of Premenopausal Breast Cancer and Childbirth Prior to Diagnosis. J Clin Oncol 2004;22(4):699-705.

  40. White TT. Carcinoma of the Breast and Pregnancy; analysis of 920 cases collected from the literature and 22 new cases. Ann Surg 1954;139(1):9-18.

  41. Kuerer HM, Cunningham JD, Brower ST, Tartter PI. Breast carcinoma associated with pregnancy and lactation. Surg Oncol 1997;6(2):93- 98.

  42. Guinee F, Hess KR, Taylor SH, Olsson H, Möller T, Fahey T, et al: Effect of pregnancy on prognosis for young women with breast cancer. Lancet 1994;343(8913):1587-1589.

  43. Daling JR, Malone KE, Doody DR, Anderson BO, Porter PL. The Relation of Reproductive Factors to Mortality from Breast Cancer. Cancer Epidemiol Biomarkers Prev 2002;11:235-241.

  44. Ewertz M, Duffy SW, Adami HO, Kvåle G, Lund E, Meirik O, et al. Age at first birth, parity and risk of breast cancer: A meta-analysis of 8 studies from the nordic countries. Int J Cancer 1990;46(4):597- 603.

  45. E von Schoultz, Johansson H, Wilking N, Rutqvist LE. Influence of prior and subsequent pregnancy on breast cancer prognosis. J Clin Oncol 1995;13(2):430-434.

  46. Doll DC, Ringenberg QS, Yarbro JW. Antineoplastic Agents and Pregnancy. Semin Oncol 1989;16(5):337-346.




2020     |     www.medigraphic.com