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Tumorerkrankungen in der Schwangerschaft

Management und Risiken

Cancer during pregnancy

Management and risks

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Bei annähernd 1 von 1000 Schwangeren wird ein Malignom diagnostiziert. Am häufigsten sind dies Zervixkarzinome, gefolgt von Hodgkin-Lymphom, Mammakarzinom und malignem Melanom. Die zunehmende Anzahl erklärt sich aus dem steigenden Alter der Schwangeren. Durch die Diagnose einer Krebserkrankung in der Schwangerschaft erscheinen mütterliches und kindliches Leben oft gleichermaßen bedroht, gewählte Therapieformen wirken sich meist gegensätzlich auf die Prognose aus. Im interdisziplinären Dialog muss versucht werden, den bestmöglichen Weg zu finden. Trotz der Zurückhaltung der Nutzung ionisierender Strahlen in der Diagnostik darf es zu keiner Verschleppung der Diagnose kommen. Der Ultraschall und die MRT stehen als Diagnoseverfahren der 1. Wahl zur Verfügung. Zu den verschiedenen Therapieoptionen liegen teilweise nur wenige Daten vor: Eine Operation ist ohne wesentliche Bedenken möglich. Eine Strahlentherapie wie auch endokrine Therapien sollten während der Schwangerschaft nicht durchgeführt werden. Mit einer Chemotherapie sollte, wenn möglich, das 2. bzw. 3. Trimenon abgewartet werden, insgesamt ist die Datenlage gering. Bezüglich der Antikörpertherapie gibt es erste ermutigende Daten, Langzeitergebnisse stehen aus. Um das Wissen in der onkologischen Behandlung Schwangerer zu verbessern, ist es wichtig, alle Fälle z. B. unter http://www.germanbreastgroup.de/pregnancy zu dokumentieren.

Abstract

The most frequent malignancy during pregnancy is cervical cancer, followed by Hodgkin’s lymphoma, breast cancer, and melanoma. Because of the older age of woman at pregnancy there has been an increase in the incidence. The diagnosis of a malignant tumor affects both the mother and her child; different therapy regimens have opposite effects on the prognosis of each one. The interdisciplinary dialogue with the mother attempts to find the optimal therapeutic modalities. Despite potentially negative effects of radiologic diagnostics, no time should be lost in finding the diagnosis. Gold standard methods are ultrasound and MRI. There is a lack of data regarding the different therapies. Surgery seems to be safe. Radiotherapy as well as endocrine therapy should not be done during pregnancy. Chemotherapy is regarded to be safe during the second and third trimesters, but it should not be applied earlier because of the teratogenic effects. Therapy with antibodies seems to be a promising treatment; long-term follow-up results are not available. In order to improve the knowledge about cancer in pregnancy, it is important to record case reports in http://www.germanbreastgroup.de/pregnancy.

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  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562 , Lübeck, Deutschland

    D. Fischer, A. Schröer, T. Cordes, D. Lüdders, K. Diedrich & M. Friedrich

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  1. D. Fischer
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  2. A. Schröer
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  3. T. Cordes
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  4. D. Lüdders
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  5. K. Diedrich
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  6. M. Friedrich
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Correspondence to D. Fischer.

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Fischer, D., Schröer, A., Cordes, T. et al. Tumorerkrankungen in der Schwangerschaft. Gynäkologische Endokrinologie 4, 223–228 (2006). https://doi.org/10.1007/s10304-006-0157-6

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  • DOI: https://doi.org/10.1007/s10304-006-0157-6

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