Neonatal loss secondary to third trimester chemotherapy for maternal breast cancer

Meme kanseri kadınlarda en sık görülen kanserdir ve hayat boyu riski %11’dir. Gebelikle ilişkili meme kanseri genellikle gebelikte veya postpartum 1 yılda tanı konulan meme kanseri olarak tanımlanır. Gebelikle ilişkili meme kanserinin kesin tedavisi cerrahidir. Lenf nodu tutulumu pozitif olan veya tümörü 1 cm’nin üstünde olan hastalarda standart tedavi 4-6 aylık dönemde verilen kemoterapidir. Kemoterapi, ilk trimester verilmediği takdirde göreceli olarak güvenli kabul edilir. 42 yaşında, gebeliğinin 3. trimesterinde olan hasta ilerlemiş meme kanseri nedeniyle başvurdu. Meme kanseri ilerlemiş olduğu ve gebeliğinin 3. trimesterinde olduğu için kemoterapi kararı alındı. Kemoterapiyi aldıktan üç hafta sonra hasta akut fetal distress nedeniyle acil sezeryana alındı. Bebek yirmi günlükken kardiopulmoner arrest nedeniyle kaybedildi. Ölüm nedeninin kemoterapiye sekonder gelişen perinatal hipoksi olduğu Kabul edildi. Birçok klinik çalışmada 2. ve 3. trimesterde verilen kemoterapinin güvenli olduğu gösterilmiş olsa da her vaka kendi içinde değerlendirilmeli ve bu gebeler daha yakın izlenmeli.

Maternal meme kanseri nedeniyle üçüncü trimesterde verilen kemoterapiye bağlı neonatal kayıp

Breast cancer is the most common cancer among women with a lifetime risk of 11%. Pregnancy-associated breast cancer is defined as cancer diagnosed during pregnancy or up to 1 year post partum. Surgery is the definitive treatment for pregnancy-associated breast cancer. For node-positive patients or node-negative patients with a tumor greater than 1 cm, a 4 to 6 month course of chemotherapy is the standard of care. Provided that chemotherapy is not used in the first trimester, it appears to be relatively safe. A forty-two year old pregnant woman in the third trimester presented with an advanced breast cancer. Since she had an advanced stage cancer and since she was in the third trimester, she was decided to be treated with chemotherapy. After three weeks, an emergent cesarean section was performed because the fetus was in acute distress. On the 20th day, the baby died because of cardiopulmonary arrest. The cause of the death was concluded as perinatal hypoxia secondary to chemotherapy. Even though chemotherapy is shown to be safe during the second and third trimester in many clinical trials, each case should be handled separately since the assumption of safety may differ in each case. These pregnants should be observed closer

Kaynakça

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