妊娠期乳腺癌.ppt

BreastCancerDiagnosedDuringPregnancy天津市肿瘤医院乳腺一科陈祖锦11

EpidemiologyTheMotheriskguidetocancerinpregnancyandlactation.2nded.Toronto,Canada:MotheriskProgram;2005.

EpidemiologyBCPbecomemorefrequent:delaychildbearingBreastcarcinomaduringpregnancy.Internationalrecommendationsfromanexpertmeeting.Cancer2006;106(2):237–46.

History：Positivefamilyhistory:48%BRCA1orBRCA2mutations:9%FamilyhistoryofbreastandovariancancersandBRCA1andBRCA2mutationsinapopulation-basedseriesofearly-onsetbreastcancer.JNatlCancerInst2001;93(16):1215–23.Diagnose

ClinicalexaminationGlandularandductalhyperplasias:palpationcannotdiscriminatemalignantfrombenignlumpsofasimilarsizediagnosiscanbedelayedDiagnose

DiagnosticRadiology

Exceedingadoseof0.05Gymaycausemalformations,microcephaly,intrauterinegrowthretardation,andmentalretardationDiagnostic

ClinicalstageIIorhigherbreastcancer：metastasesbone,liver,andlungChestx-raywithabdominalshielding;UltrasoundofthelivernoncontrastMRIexclude:livermetastasesthoracicandlumbarspinebonemetastases.CTscansandbonescansarenotrecommendedforroutineuseEchocardiogram:anthracycline-basedchemotherapyregimenDiagnosticStagingevaluation

Treatmentimplantation(0-2weeks),organogenesis(2-10weeks),fetalphase(10weeks)

Treatment:LocoregionalTherapy

SLNBEstimatedradiationexposuretothefetusislowandcalculatedtoamaximumof4.3mGyBluedyeshouldnotbeused：anaphylaxisbeharmfulforthefoetus---SensitivitydecreasedThesensitivityandspecificityofSLNPhasnotbeenwellestablishednotthetechnicalaspectsaccuracyPregnancy-associatedbreastcancerpatientscansafelyundergolymphaticmapping.BreastJ2008;14(3):250–4.Treatment

RadiationtherapyduringpregnancyisrarelyindicatedinBCP.Ingeneral,itisrecommendedtopostponeRTuntilafterdeliveryDuringthefirstmonthsofpregnancy,theuterusdoes