Vall d'Hebron Hospital successfully treats pregnant women with breast cancer
The medical team responsible for this protocol has opened up research lines focusing on how chemotherapy affects the fetus.
The Vall d'Hebron University Hospital in Barcelona has treated 24 pregnant women with breast cancer, achieving the same results as in non-pregnant patients. This has been made possible through a holistic treatment protocol initiated in 2006 by the hospital’s Breast Cancer Unit, which involves a multidisciplinary team of specialists in gynecology, obstetrics, fetal medicine, oncology, breast-cancer surgery and pediatrics.
Although it is rare for women to be diagnosed with breast cancer during pregnancy –only 2.3 out of every 100,000 cases— this figure is increasing as women are waiting longer and longer to have children. Twenty years ago, only 35% of women became pregnant around the age of 35 but now this is the average age that women have their first child in Spain.
Patients diagnosed with cancer during pregnancy have the option to terminate or continue with the pregnancy. So far, most women have chosen the first option because they didn’t see any clear alternative. Currently, Vall d’Hebron Hospital duly informs patients of their options, allowing them to continue the pregnancy and receive the most appropriate treatment.
These patients require exhaustive monitoring beginning from the time they are diagnosed, when the multidisciplinary team chooses the best medical strategy taking into account both the stage of pregnancy and development of the tumor. With this information, the team decides whether to begin treatment with chemotherapy or with surgery, and establishes a treatment timeline seeking optimum efficacy for the mother and safety for the fetus. Before each chemotherapy session, the patient undergoes analyses, an ultrasound, and visits with the oncologist and obstetrician in order to ensure that the fetus is developing properly.
Over the years this protocol has been in place, breakthroughs in the field have been integrated to treat patients, including selective sentinel lymph-node biopsies, taxane-based chemotherapy and fetal echocardiographic screening, among others, which have led to results comparable to those seen in non-pregnant patients, without harming the fetus.
The experience acquired through this protocol has also allowed the medical team in charge to carry out develop projects to improve the results achieved in the future. These lines of research focus on the various effects of chemotherapy on the fetus, and are being carried out jointly with international groups specializing in cancer and pregnancy in order to continue improving these protocols.
More information is available on the Vall d'Hebron Research Institute website.