内容紹介
Summary
A 33-year-old woman became aware of a right breast mass at her 28th week of pregnancy. From the biopsy results, we diagnosed her with right breast cancer. At her 33rd week of pregnancy, she underwent modified radical mastectomy(pT2N3aM0, Stage ⅢC, ER-negative, PR-negative, HER2-positive), and she elected to receive adjuvant therapy after the surgery during her pregnancy. She received the first course of EC(epirubicin plus cyclophosphamide)therapy on the 13th postoperative day(35 weeks of gestation)and gave a natural, vaginal delivery at 36 weeks and 5 days of gestation. On the 4th day after birth, the patient noticed a contralateral left breast mass and was diagnosed with left breast cancer, after core needle biopsy. She received 4 courses of EC therapy and is currently undergoing PTX plus HER(paclitaxel plus trastuzumab)therapy. Regarding chemotherapy during pregnancy, we recommend that there is no need to perform artificial preterm birth, because chemotherapy has little influence on children after their second-trimester. After the second-trimester, chemotherapy can be safely performed.
要旨
症例は33歳,女性。妊娠28週で右乳房腫瘤を自覚,右乳癌と診断され妊娠33週0日で胸筋温存乳房切除術を施行した。papillo-tubular carcinoma,pT2N3aM0,Stage ⅢC,ER陰性,PR陰性,HER2陽性と診断され,術後薬物補助療法を施行した。妊娠中の治療を選択し,術後13日目(妊娠35週)でEC療法1コース目を施行した。妊娠36週5日に自然経腟分娩となった。産後4日目に対側の左乳房腫瘤を自覚し左乳癌と診断した。EC療法4コース終了。現在PTX+HER療法を進行中である。妊娠中の化学療法については,妊娠中期以降は胎児への影響が比較的少なく安全に施行できることから,化学療法を先行させた。
目次
A 33-year-old woman became aware of a right breast mass at her 28th week of pregnancy. From the biopsy results, we diagnosed her with right breast cancer. At her 33rd week of pregnancy, she underwent modified radical mastectomy(pT2N3aM0, Stage ⅢC, ER-negative, PR-negative, HER2-positive), and she elected to receive adjuvant therapy after the surgery during her pregnancy. She received the first course of EC(epirubicin plus cyclophosphamide)therapy on the 13th postoperative day(35 weeks of gestation)and gave a natural, vaginal delivery at 36 weeks and 5 days of gestation. On the 4th day after birth, the patient noticed a contralateral left breast mass and was diagnosed with left breast cancer, after core needle biopsy. She received 4 courses of EC therapy and is currently undergoing PTX plus HER(paclitaxel plus trastuzumab)therapy. Regarding chemotherapy during pregnancy, we recommend that there is no need to perform artificial preterm birth, because chemotherapy has little influence on children after their second-trimester. After the second-trimester, chemotherapy can be safely performed.
要旨
症例は33歳,女性。妊娠28週で右乳房腫瘤を自覚,右乳癌と診断され妊娠33週0日で胸筋温存乳房切除術を施行した。papillo-tubular carcinoma,pT2N3aM0,Stage ⅢC,ER陰性,PR陰性,HER2陽性と診断され,術後薬物補助療法を施行した。妊娠中の治療を選択し,術後13日目(妊娠35週)でEC療法1コース目を施行した。妊娠36週5日に自然経腟分娩となった。産後4日目に対側の左乳房腫瘤を自覚し左乳癌と診断した。EC療法4コース終了。現在PTX+HER療法を進行中である。妊娠中の化学療法については,妊娠中期以降は胎児への影響が比較的少なく安全に施行できることから,化学療法を先行させた。