Abstract
The main goal of precision medicine in patients with breast cancer is to tailor the treatment according to the particular genetic makeup and the genetic changes in the cancer cells. Breast cancer occurring during pregnancy (BCP) is a complex and difficult clinical problem. Although it is not very common, both maternal and fetal outcome must be always considered when planning treatment. Pregnancy represents a significant barrier to the implementation of personalized treatment for breast cancer. Tailoring therapy mainly takes into account the stage of pregnancy, the subtype of cancer, the stage of cancer, and the patient’s preference. Results of the treatment of breast cancer in pregnancy are as yet not very satisfactory because of often delayed diagnosis, and it usually has an unfavorable outcome. Treatment of patients with pregnancy-associated breast cancer should be centralized. Centralization may result in increased experience in diagnosis and treatment and accumulated data may help us to optimize the treatment approaches, modify general treatment recommendations, and improve the survival and quality of life of the patients.
Highlights
The need to protect the fetus from the adverse events associated with the treatment of cancer represents a significant barrier to the implementation of genomic and molecular biological personalization of treatment in a subgroup of pregnant patients with breast cancer
breast cancer diagnosed during pregnancy (BCP) is a special situation of concomitant pregnancy and cancer and, due to different subtypes of breast cancer, tumor detection at different stages and diagnosis confirmed at different trimesters of pregnancy does not allow the application of only one standard treatment approach
Pregnancy and lactation are associated with increased levels of estrogens with the impairment of their normal cyclical pattern resulting in resultant molecular and histological changes in the breast gland
Summary
The need to protect the fetus from the adverse events associated with the treatment of cancer represents a significant barrier to the implementation of genomic and molecular biological personalization of treatment in a subgroup of pregnant patients with breast cancer. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy (BCP) or in the first postpartum year or at any time during lactation. Pregnant patients with breast cancer do not yet benefit from these advances in precision medicine. In clinical practice we are more often faced with the need to treat patients with a very advanced stage of cancer, frequently with the presence of metastases in the skeleton or visceral organs
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