Breast cancer during pregnancy (BCP) is an important subgroup within the young and very young breast cancer patients. It accounts for about 1% of all breast cancers. Due to an increased awareness, the attitude towards breast cancer during pregnancy has changed and, today, women with BCP are more likely to receive standard chemotherapy and have a term delivery instead of being advised to interrupt the pregnancy or undergo an early preterm delivery. This increased knowledge is based on small cohort studies and international collaborations such as the registry by the German Breast Group for BCP and the initiative of the European Society of Gynaecological Oncology (ESGO). Guidelines and recommendations such as the German guidelines by the AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, www.ago-online.org) and the National Comprehensive Cancer Network (NCCN) guidelines include recommendations for BCP. In general, surgery and chemotherapy (beyond the 13th week of gestation) can be safely performed during pregnancy. Chemotherapy should follow the treatment recommendations for breast cancer in young women. Trastuzumab, endocrine treatment, and radiotherapy are not indicated during pregnancy. Preterm delivery should be avoided as far as possible because it bears a higher risk of infant morbidity and mortality. The treatment of BCP should be planned within a multidisciplinary team including perinatologists, obstetricians and neonatologists.
Das Mammakarzinom in der Schwangerschaft ist mit 1% aller Mammakarzinome selten. Es bildet jedoch einen wichtigen Aspekt der jungen und sehr jungen Frauen mit Mammakarzinom. Ein gesteigertes Bewusstsein für diese seltene Koinzidenz hat dazu beigetragen, dass die Frauen heute mit höherer Wahrscheinlichkeit eine Standardtherapie erhalten und nicht vorzeitig entbunden werden. Es wird seltener, dass den Frauen zu einem Schwangerschaftsabbruch geraten oder ihnen eine vorzeitige Entbindung anempfohlen wird. Unser heutiges Wissen stammt aus kleinen Kohortenstudien, aber auch aus internationalen Registern wie das der German Breast Group zum Mammakarzinom in der Schwangerschaft oder der Initiative der ESGO (European Society of Gynaecological Oncology). Leitlinien zum Mammakarzinom wie die der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO,