Naslov
Dilemmas in therapy of gestational breast cancer: Review of literature
(Dilemmas in Therapy of Gestational Breast Cancer: Review of Literature)

Autori
Fajdić, Josip ; Gotovac, Nikola ; Hrgović, Zlatko

Izvornik
Tumor Diagnostik und Therapie (0722-219X) 29 (2008), 2; 91-95

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Dilemmas in therapy ; Gestational breast cancer ; Review of literature

Sažetak
Purpose: Goal of this review is, by using data of mostly retrospective studies and other available publications, to point out that besides most of cleared problems, there are several dilemmas in GBC treatment. Patients and methods: Reviewing protocols using Medline database as well as conclusions from meetings specialized on this topic, we found that greatest problems are in chemotherapy and irradiation of patients in I. and II. trimester. Problems in surgical part of treatment are considerably smaller. Results: Majority of used publications bring us clear positions about surgical treatment of GBC where modified radical mastectomy is prevailing, regardless to stage of disease or pregnancy. But, there are possibilities for usage of breast conserving surgery in cases with lower grade of the disease, if postoperative irradiation is used. As far as radiotherapy of GBC is used, majority of protocols consider clear understanding of risks that radiation carries for the fetus, and how the risk is to be analyzed considering stage of pregnancy, or in other words, stage of fetal development. Without doubt, highest level of deletory effects of radiation is in first trimester, during implantation in first ten days, and after, during organogenesis. Success and models used in chemotherapy in GBC is also dependable on stage of the pregnancy. All publications state clearly that chemotherapy is not acceptable in first trimester of pregnancy, due to all neuro and cardio toxic effects and considerable growth retardation. If needed during third trimester, chemotherapy can be delayed after delivery. There is consensus today that therapeutic abortion is to be avoided, except clearly defined cases of GBC. Conclusion: Biggest problem in getting the multidisciplinary treatment of GBC more clear is small number of prospective studies, while retrospective studies are based on tracking the patients after long periods after the treatment of GBC as well as patients treated by several physicians and using sometimes different approaches. It still remains to be said, literature shows today that stage of pregnancy, or in other words, age of fetus, is base criteria for any kind of treatment of GBC.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA