Breast cancer in pregnancy - hopetomatchsoon

[ArchivalUser]

According to MTB, breast conserving therapy is not the answer when the patient is pregnant. So if a patient who is pregnant turns out to have ductal breast cancer for example, how should she be treated? Or do we even treat her while she's still pregnant?

[ArchivalUser]

Management is similar to non-pregnant patients...Just avoid endocrine (tamoxifen) therapy and Radiation therapy until after delivery

use chemotherapy after first trimester and stop 1 month before delivery

breastfeeding safe after treatment but not while using chemotherapy.

Breast conserving therapy/Mastectomy is safe in pregnancy.

[ArchivalUser]

Ok thanks. But why is MTB stating that breast conserving therapy is not the answer when the patient is pregnant? That's what I don't understand.

[ArchivalUser]

what page?

[ArchivalUser]

Page 421. Mine is second edition.

[ArchivalUser]

"Pregnancy is an absolute contraindication to the use of breast irradiation; however, it may be possible to perform breast-conserving surgery in the third trimester, deferring breast irradiation until after delivery."

I'm assuming cince BCT is paired with Radiation therapy , he put that up as contraindication in Kaplan.