Neonatal Loss Secondary to Third Trimester Chemotherapy for Maternal Breast Cancer

Abstract

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