Pregnancy and breast cancer GTG

Question 1

What is the lifetime risk of breast cancer?

Answer 1

1 in 9

Question 2

What % of women with breast cancer are under 40 years

Answer 2

15%

Question 3

How common is breast cancer in pregnancy?

Answer 3

1 in 3000

Question 4

What is the 5 year survival if Dx <50 years

Answer 4

50% at 5 years

Question 5

What % of women who have had breast cancer then become pregnancy?

Answer 5

10%

Question 6

If breast lump found in pregnancy

Answer 6

Refer to breast specialist
USS, if mammogram needed can be performed with sheilding
USS guided Bx

Question 7

What imaging can be used to assess for mets in pregnancy?

Answer 7

CXR
Liver USS

Not to perform CT
Can consider MRI

Question 8

Can surgery be performed in pregnancy?

Answer 8

Surgical Tx including local lymph clearance can be performed in all trimesters

Avoid reconstruction until after pregnancy

Question 9

Can radiotherapy be performed in pregnancy?

Answer 9

Contraindicated until delivery

Question 10

Can systemic chemotherapies be given

Answer 10

Contraindicated in 1 st trimester but safe in 2nd

Advise anthracycine regiemes

Question 11

Can tamoixfen be given in pregnancy

Answer 11

No

Question 12

Can trastuzumab be given in pregnancy

Answer 12

No

Question 13

When should birth be timed with last chemo?

Answer 13

2-3 weeks after

Question 14

When can breast feeding commence after chemo?

Answer 14

After 14 dayss from last chemo

Question 15

Can you breast feed whilst taking tamoxifen or trastuzumab?

Answer 15

No

Question 16

For how long should tamoxifen be stopped before trying to conceive?

Answer 16

3 months

Question 17

Is long term survival after breast cancer effect by pregnancy?

Answer 17

No but would not advise if metastatic disease

Question 18

Generally how long to wait after treatment of breast cancer for conceiving?

Answer 18

2 years, because highest risk of recurrence

Question 19

If previous BC what test should be performed in pregnancy?

Answer 19

ECHO

Question 20

What is the risk of chemotherapy induced amenohorrhea
< 30yrs
36-40yrs

Answer 20

<30 <5%
36-40 50%

Question 21

Does tamoxifen/ GnRh analogue/transtuzuman cause subfertility

Answer 21

No but can can menstrual irregularity