master's thesis
Trudnoća u žena oboljelih od hormonski ovisnog raka dojke

Ivana Radovčić (2015)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za onkologiju i radioterapiju
Metadata
TitleTrudnoća u žena oboljelih od hormonski ovisnog raka dojke
AuthorIvana Radovčić
Mentor(s)Marija Petković (thesis advisor)
Abstract
Rak dojke povezan s trudnoćom je rak dojke koji se javlja u trudnica i tijekom dojenja unutar jedne godine od porođaja. Najčešći patohistološki nalaz je invazivni duktalni karcinom. Većina tumora pokazuje visoku diferenciranost, limfovaskularnu invaziju i hormonsku neovisnost. Najčešće korištene pretrage za potvrdu karcinoma dojke su mamografija i ultrazvučni pregled. Za odabir najprikladnije terapije treba uzeti u obzir proširenost bolesti, tjedan trudnoće i razvijenost fetusa te želje i zahtjevi trudnice i obitelji. Kirurški zahvat se obavlja tijekom cijele trudnoće. Radioterapija je kontraindicirana zbog izlaganja fetusa zračenju. Kemoterapija se ordinira tijekom drugog i trećeg tromjesečja, dok je u prvom tromjesečju kontraindicirana zbog teratogenog učinka na fetus. Najčešće se propisuje FAC – protokol koji uključuje 5 – fluorouracil, doksorubicin i ciklofosfamid zbog minimalnog rizika za razvoj fetusa ili dojenčeta. Ne preporučuje se primati kemoterapiju nakon 35. tjedna gestacije jer se na taj način smanjuje rizik za razvoj neutropenije u majke i novorođenčeta tijekom i nakon poroda. Hormonska terapija, ako je indicirana, se ordinira nakon poroda i završetka ciklusa kemoterapije. Tamoksifen se ne preporučuje kao lijek izbora tijekom trudnoće jer ima teratogen učinak na razvoj fetusa. Nije uočena potreba za drukčijom vrstom prenatalnog praćenja fetusa u oboljelih trudnica te se fetus može pratiti standardnim načinom. Ako je planiran nastavak kemoterapije nakon poroda, preporučuje se vaginalni porod jer su manje šanse za komplikacije uspoređujući s carskim rezom. Dojenje tijekom kemoterapije i hormonalne terapije je kontraindicirano.
Keywordsbreast cancer pregnancy
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za onkologiju i radioterapiju
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Oncology
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2015
Parallel abstract (English)
Pregnancy – associated breast cancer is a breast cancer diagnosed during pregnancy or the lactation period up to first postpartum year. Most common histopathological type is invasive ductal carcinoma. Majority of tumors are highly differentiated, hormone independent and they invade surrounding lymph vessels. Most common diagnostic imaging procedures during pregnancy are mammography and ultrasound. Patient’s stage of disease, gestational age, development of the fetus and the preferences of the patient and family needs to be taken into consideration for the selection of the most appropriate therapy. Breast surgery can be safely performed during all trimesters of pregnancy. Radiation is contraindicated because of the feta exposure to radiation. Chemotherapy is prescribed during second and third trimester and it is contraindicated during the first trimester of pregnancy because of the risk of teratogenicity. Most common used protocol is FAC – protocol which consists of 5 – fluorouracil, doxorubicin and cyclophosphamide because of the minimal risk to the fetus or the infant. Chemotherapy should not be given after the 35th week of gestation in order to minimize the risk of neutropenia in mother and newborn during and after the delivery. Hormone therapy, if indicated, is given after the delivery and after chemotherapy. Tamoifen is not recommended during pregnancy because of the risk of teratogenicity. There is no need for different kind of prenatal care of fetus in patients with breast cancer. Therefore, fetus can be monitored with standard prenatal care. If chemotherapy is planned to continue after the delivery, vaginal delivery is recommended because of the lesser complications comparing to cesarean section. Breastfeeding during radiation and chemotherapy is contraindicated.
Parallel keywords (Croatian)rak dojke trudnoća
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:154403
CommitterBosa Licul