臨床婦人科産科73巻5号

2019年05月発行

今月の臨床 妊婦の腫瘍性疾患の管理―見つけたらどう対応するか 悪性疾患

妊婦の乳がんの管理

著者： 佐々木浩¹

所属機関： ¹大阪医科大学産婦人科

ページ範囲：P.487 - P.493

●妊娠関連乳がんは近年の晩婚化，高齢出産の増加により，増加傾向である．

●妊娠関連乳がんは非妊娠乳がんに比較して，腫瘍が大きい，リンパ節転移が多い，ホルモン受容体陰性が多いとされている．

●妊娠期乳がんの治療は，妊娠中期以降に手術・抗がん剤治療を行い，内分泌療法や抗HER2療法は出産後に行うことが勧められる．

参考文献

1）Ishida T, et al : Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation : analysis of case-control study in Japan. Jpn J Cancer Res 83 : 1143-1149, 1992

2）Andersson TM, et al : Increasing incidence of pregnancy-associated breast cancer in Sweden. Obstet Gynecol 114 : 568-572, 2009

3）Azim HA Jr, et al : Prognosis of pregnancy-associated breast cancer : a meta-analysis of 30 studies. Cancer Treat Rev 38 : 834-842, 2012

4）Amant F, et al : Prognosis of women with primary breast cancer diagnosed during pregnancy : results from an international collaborative study. J Clin Oncol 31 : 2532-2539, 2013

5）大野和子 : 妊娠と画像診断．臨画像26 : 109-113, 2010

6）Gentilini O, et al : Sentinel lymph node biopsy in pregnant patients with breast cancer. Eur J Nucl Med Mol Imaging 37 : 78-83, 2010

7）Gropper AB, et al : Sentinel lymph node biopsy in pregnant women with breast cancer. Ann Surg Oncol 21 : 2506-2511, 2014

8）Giacalone PL, et al : Chemotherapy for breast carcinoma during pregnancy : A French national survey. Cancer 86 : 2266-2272, 1999

9）Cardonick E, et al : Use of chemotherapy during human pregnancy. Lancet Oncol 5 : 283-291, 2004

10）Hahn KM, et al : Treatment of pregnant breast cancer patients and outcomes of children exposed to chemotherapy in utero. Cancer 107 : 1219-1226, 2006

11）Fruscio R, et al : Ovarian cancer in pregnancy. Best Pract Res Clin Obstet Gynaecol 41 : 108-117, 2017

12）Sood AK, et al : Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy. Gynecol Oncol 83 : 599-600, 2001

13）Braems G, et al : Use of tamoxifen before and during pregnancy. Oncologist 16 : 1547-1551, 2011

14）Zagouri F, et al : Trastuzumab administration during pregnancy : a systematic review and meta-analysis. Cancer Res Treat 137 : 349-357, 2013