سرطان پستان در حاملگی

طوسی, منیره; همتی, سیمین; محمدیان پناه, محمد

سرطان پستان در حاملگی

نوع مقاله : مقاله مروری

نویسندگان

¹ کارشناس ارشد، گروه مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

² دانشیار، گروه رادیوتراپی و آنکولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

³ استاد، گروه رادیوتراپی و آنکولوژی، مرکز تحقیقات کولورکتال، دانشگاه علوم پزشکی شیراز، شیراز، ایران

چکیده

تومورهای بدخیم دومین علت شایع مرگ و میر در زنان در طی سنین باروری می‌باشند؛ اما وقوع سرطان در حین حاملگی نادر است و تنها 02/0 تا 1/0 درصد تمام حاملگی‌ها همراه با سرطان است. با افزایش میزان حاملگی در سنین بالا، شیوع سرطان حین بارداری نیز در حال افزایش است. سرطان پستان دومین سرطان شایع تظاهر کننده حین بارداری می‌باشد. سرطان پستان همراه با بارداری به سرطانی که در طی بارداری، شیردهی و یا یک سال بعد از زایمان بروز می‌کند، اطلاق می‌گردد. تغییرات فیزیولوژیک مربوط به بارداری و وجود جنین مهم‌ترین چالش‌ها در تشخیص و درمان زنان باردار هستند. نشانه‌ها و علایم حاملگی می‌تواند سرطان پستان را در یک خانم حامله پنهان کند و منجر به تأخیر در تشخیص سرطان شود. همچنین، به دلیل نگرانی از سلامتی جنین، محدودیت‌ها و موارد منع زیادی برای استفاده از روش‌های تشخیصی و درمانی در حین حاملگی وجود دارد. به دلیل فقدان مطالعات گروهی و کارآزمایی‌ای بالینی بزرگ، پرسش‌های بسیاری در مورد پیامدهای تشخیص و درمان سرطان پستان در حاملگی بدون پاسخ باقی می‌ماند. در این مقاله، ما مهم‌ترین چالش‌ها و رویکردهای تشخیصی و درمانی در این گروه از بیماران را مرور می‌کنیم.

کلیدواژه‌ها

عنوان مقاله [English]

Breast Cancer in Pregnancy

نویسندگان [English]

Monireh Toosi ¹
Simin Hemati ²
Mohammad Mohammadianpanah ³

¹ Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

² Associate Professor, Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ Professor, Department of Radiation Oncology, Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

چکیده [English]

Malignant neoplasms are the second most common cause of death in women during childbearing age; however, the occurrence of cancer during pregnancy is rare and only 0.02-0.1 percent of all pregnancies is associated with cancer. By increasing the rate of pregnancies in older ages, the incidence of cancer during pregnancy is also being increased. Breast cancer is the second most frequent cancer presenting during pregnancy. Pregnancy-associated breast cancer is defined as breast cancer that is diagnosed during pregnancy, lactation in or at the first postpartum year. Physiologic changes related to the pregnancy and the fetus are the most important diagnostic and therapeutic challenges in pregnant women. The signs and the symptoms of the pregnancy can mask breast cancer in a pregnant woman and lead to late cancer diagnosis. In addition, concerning fetus safety, there are many limitations and contraindications for using diagnostic and therapeutic methods during pregnancy. Due to the absence of major cohort srudies and large randomized trials, many questions regarding the consequences of the diagnosis and treatment of breast cancer in pregnancy remain unanswered. In this article, we review the most important diagnostic and therapeutic challenges and approaches in this group of patients.

کلیدواژه‌ها [English]

Breast Cancer
Pregnancy
Diagnosis
Surgery
Chemotherapy
Radiotherapy

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