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. 1979 Apr 28;1(6171):1124–1127. doi: 10.1136/bmj.1.6171.1124

Mammary cancers and pregnancy.

J M Anderson
PMCID: PMC1598766  PMID: 376044

Abstract

Uncertainties persist about management and prognosis of mammary cancers that occur during and after pregnancy and during lactation. Pathological features of mammary cancers occurring during pregnancy are the same as those in non-pregnant women and survival rates are comparable. Management should be the same as in non-pregnant patients. Termination of pregnancy does not improve survival but it should be advised if the prognosis is poor. Mastectomy apparently presents little danger to the fetus, though treatment such as chemotherapy and irradiation should be avoided. Women who have received treatment for mammary cancer need not be advised against subsequent pregnancy. Routine ovarian radiation in non-pregnant premenopausal women is not generally to be recommended, since it does not prolong survival and would deprive some of the chance of further pregnancy. In lactating women who develop mammary cancers survival is apparently not adversely affected. Lactation should be suppressed initially and followed by mastectomy. Regimens of immunotherapy, chemotherapy, or radiotherapy may then be begun. Until results of current trials of combined treatments of mammary cancers associated with pregnancy are available, management should be neither aggressive nor tentative. It should be based on a well-balanced concept of applying all available treatments, as in non-pregnant patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. M., De Sousa M. A., Halnan K. E., Kelly F., Hannah G. Assessment of immunization by autotransplantation of human cancer. Br J Surg. 1970 Aug;57(8):557–561. doi: 10.1002/bjs.1800570802. [DOI] [PubMed] [Google Scholar]
  2. Anderson J. M., Kelly F., Gettinby G. Stimulatory immunotherapy with autografts of mammary cancers. Dev Biol Stand. 1977 Apr 13;38:433–440. [PubMed] [Google Scholar]
  3. Anderson J. M., Kelly F., Gettinby G., Wood S. E. Prolonged survival after immunotherapy (irradiated cancer autografts) or mammary cancers, assessed by a measure of therapeutic deficiency. Cancer. 1977 Jul;40(1):30–35. doi: 10.1002/1097-0142(197707)40:1<30::aid-cncr2820400107>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  4. Anderson J. M., Kelly F., Wood S. E., Halnan K. E. Stimulatory immunotherapy in mammary cancer. Br J Surg. 1974 Oct;61(10):778–784. doi: 10.1002/bjs.1800611009. [DOI] [PubMed] [Google Scholar]
  5. BLOOM H. J., RICHARDSON W. W. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957 Sep;11(3):359–377. doi: 10.1038/bjc.1957.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. BRODSKY I., BAREN M., KAHN S. B., LEWIS G., Jr, TELLEM M. METASTATIC MALIGNANT MELANOMA FROM MOTHER TO FETUS. Cancer. 1965 Aug;18:1048–1054. doi: 10.1002/1097-0142(196508)18:8<1048::aid-cncr2820180817>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  7. BUNKER M. L., PETERS M. V. Breast cancer associated with pregnancy or lactation. Am J Obstet Gynecol. 1963;85:312–321. doi: 10.1016/s0002-9378(16)35439-4. [DOI] [PubMed] [Google Scholar]
  8. Bonadonna G., Brusamolino E., Valagussa P., Rossi A., Brugnatelli L., Brambilla C., De Lena M., Tancini G., Bajetta E., Musumeci R. Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med. 1976 Feb 19;294(8):405–410. doi: 10.1056/NEJM197602192940801. [DOI] [PubMed] [Google Scholar]
  9. Brown I., Ward H. W. Doxorubicin in the treatment of advanced breast cancer; comparative studies of three combination chemotherapy regimes. Clin Oncol. 1976 Jun;2(2):105–111. [PubMed] [Google Scholar]
  10. CADE S. CANCER IN PREGNANCY. J Obstet Gynaecol Br Commonw. 1964 Jun;71:341–348. doi: 10.1111/j.1471-0528.1964.tb04292.x. [DOI] [PubMed] [Google Scholar]
  11. Carter S. K. Integration of chemotherapy into combined modality treatment of solid tumors VII. Adenocarcinoma of the breast. Cancer Treat Rev. 1976 Sep;3(3):141–174. doi: 10.1016/s0305-7372(76)80020-5. [DOI] [PubMed] [Google Scholar]
  12. Carter S. K. Single and combination nonhormonal chemotherapy in breast cancer. Cancer. 1972 Dec;30(6):1543–1555. doi: 10.1002/1097-0142(197212)30:6<1543::aid-cncr2820300621>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  13. Fisher B., Carbone P., Economou S. G., Frelick R., Glass A., Lerner H., Redmond C., Zelen M., Band P., Katrych D. L. 1-Phenylalanine mustard (L-PAM) in the management of primary breast cancer. A report of early findings. N Engl J Med. 1975 Jan 16;292(3):117–122. doi: 10.1056/NEJM197501162920301. [DOI] [PubMed] [Google Scholar]
  14. HOLLEB A. I., FARROW J. H. BREAST CANCER AND PREGNANCY. A REPORT OF 283 PATIENTS. Acta Unio Int Contra Cancrum. 1964;20:1480–1482. [PubMed] [Google Scholar]
  15. Haagensen C. D. Cancer of the breast in pregnancy and during lactation. Am J Obstet Gynecol. 1967 May 1;98(1):141–149. doi: 10.1016/0002-9378(67)90145-7. [DOI] [PubMed] [Google Scholar]
  16. Haagensen C. D., Stout A. P. CARCINOMA OF THE BREAST: II. CRITERIA OF OPERABILITY. Ann Surg. 1943 Nov;118(5):859–870. doi: 10.1097/00000658-194311850-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Harrington S. W. CARCINOMA OF THE BREAST RESULTS OF SURGICAL TREATMENT WHEN THE CARCINOMA OCCURRED IN THE COURSE OF PREGNANCY OR LACTATION AND WHEN PREGNANCY OCCURRED SUBSEQUENT TO OPERATION (1910-1933). Ann Surg. 1937 Oct;106(4):690–700. doi: 10.1097/00000658-193710000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. MONTGOMERY T. L. Detection and disposal of breast cancer in pregnancy. Am J Obstet Gynecol. 1961 May;81:926–933. doi: 10.1016/s0002-9378(15)33440-2. [DOI] [PubMed] [Google Scholar]
  19. MacMahon B., Lin T. M., Lowe C. R., Mirra A. P., Ravnihar B., Salber E. J., Trichopoulos D., Valaoras V. G., Yuasa S. Lactation and cancer of the breast. A summary of an international study. Bull World Health Organ. 1970;42(2):185–194. [PMC free article] [PubMed] [Google Scholar]
  20. Miller R. W., Blot W. J. Small head size after in-utero exposure to atomic radiation. Lancet. 1972 Oct 14;2(7781):784–787. doi: 10.1016/s0140-6736(72)92145-9. [DOI] [PubMed] [Google Scholar]
  21. PETERS M. V., MEAKIN J. W. THE INFLUENCE OF PREGNANCY IN CARCINOMA OF THE BREAST. Prog Clin Cancer. 1965;10:471–506. [PubMed] [Google Scholar]
  22. RIGBY P. G., HANSON T. A., SMITH R. S. PASSAGE OF LEUKEMIC CELLS ACROSS THE PLACENTA. N Engl J Med. 1964 Jul 16;271:124–127. doi: 10.1056/NEJM196407162710304. [DOI] [PubMed] [Google Scholar]
  23. Ribeiro G. G., Palmer M. K. Breast carcinoma associated with pregnancy: a clinician's dilemma. Br Med J. 1977 Dec 10;2(6101):1524–1527. doi: 10.1136/bmj.2.6101.1524. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rojas A. F., Feierstein J. N., Mickiewicz E., Glait H., Olivari A. J. Levamisole in advanced human breast cancer. Lancet. 1976 Jan 31;1(7953):211–215. doi: 10.1016/s0140-6736(76)91337-4. [DOI] [PubMed] [Google Scholar]
  25. WHITE T. T. Carcinoma of the breast in the pregnant and the nursing patient; review of 1,375 cases. Am J Obstet Gynecol. 1955 Jun;69(6):1277–1286. doi: 10.1016/s0002-9378(16)38162-5. [DOI] [PubMed] [Google Scholar]

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