Zusammenfassung
Die Prognose eines schwangerschaftsassoziierten Mammakarzinoms wurde früher als sehr ungünstig bewertet. Beim Vergleich von Tumorstadium und klassischen Prognosefaktoren dieses Kollektivs mit dem von Frauen, die außerhalb einer Schwangerschaft an einem Mammakarzinom erkranken, zeigen aktuellere Daten ähnliche Krankheitsverläufe. Allerdings werden bei Schwangeren bei der Erstdiagnose häufig fortgeschrittenere Befunde festgestellt. Hinsichtlich Diagnostik und Therapie bei Graviden wird empfohlen, die Operation wie bei einer nicht schwangeren Patientin durchzuführen, während eine Radiatio erst nach der Entbindung erfolgen sollte. Für die Wahl der systemischen Therapie ist der Zeitpunkt der Applikation des Chemotherapeutikums von großer Bedeutung. Über den Einsatz einer antihormonellen Therapie während der Schwangerschaft gibt es extrem wenige Daten, diese sollte daher postpartal erfolgen.
Abstract
In the past, pregnancy-associated breast cancer was thought to have a fatal prognosis. However, when they are comparable in terms of tumor size, nodal status, and other established prognostic markers, pregnant and nonpregnant breast carcinoma patients have more recently been found to have a similar course. Nonetheless, the stage found at the time of the initial diagnosis is often more advanced in pregnant women. It is recommended that surgery should be performed in these patients in the same way as if they were not pregnant, while radiotherapy should be postponed until after delivery. The timing of administration is important in selection of the agent for any chemotherapy. Data on endocrine treatment during pregnancy is extremely scarce, and such therapy should therefore not be implemented until after delivery.
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Lenhard, M.S., Himsl, I., Ditsch, N. et al. Schwangerschaftsassoziiertes Mammakarzinom. Onkologe 12, 471–482 (2006). https://doi.org/10.1007/s00761-006-1049-z
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DOI: https://doi.org/10.1007/s00761-006-1049-z