Breast Cancer Treatment Safe During Pregnancy

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Sixty-three percent of the infants had no neonatal complications, the Houston doctor said. One child was born with Down's syndrome and another with a clubfoot, neither related to chemotherapy.

"Among the mothers, 75 percent are alive without breast cancer recurrence," Theriault said. In addition, there appeared to be no difference in outcome among women with breast cancer who were pregnant compared with those who were not pregnant, he said.

The bottom line, according to Theriault: "Termination of pregnancy is not required to provide treatment and has no benefit in the perspective of the cancer."

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That doesn't mean that a woman's pregnancy has no impact on her breast cancer treatment, however. Theriault said radiation therapy remains the one intervention that can't be used, since it can adversely affect the fetus. Mastectomy is the most common breast cancer treatment for pregnant patients, because most pregnant women are diagnosed in an advanced stage of the disease. Breast-conserving "lumpectomy" surgery is also possible for some women, Theriault added.

Radiation, if needed in addition to surgery, can be postponed until after the baby is born, the Houston expert said. And women can receive chemotherapy during pregnancy, but, "we usually try to time our chemotherapy, so the last cycle will end three weeks before delivery," Theriault said. "We try to avoid the potential for low white-blood-cell count, low platelet counts or anemia," he added.

"This is a very important paper," said Dr. Carolyn D. Runowicz, president of the American Cancer Society and director of the Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center.

Runowicz noted that newer, highly-targeted cancer therapies probably would not be appropriate for pregnant patients because of their potential effect on the fetus. "There are so many similarities between cancer and pregnancy," she said. "We could learn a lot about cancer by understanding pregnancy. But we have to be really careful about some of these targeted therapies that we don't target a growing baby as well as a cancerous tumor," she added.

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