BREAST CANCER AND WOMAN’S REPRODUCTIVE FUNCTION (LITERATURE REVIEW)

Abstract

Breast cancer (BC) heads a list of diseases of women in Russia, almost one fourth of all patients are in reproductive age. In 2009 BC was diagnosed in 23 % of all women younger than 45 y. o., who were diagnosed the malignant neoplasm for the first time. Polychemotherapy has a gonadotoxic effect, when the disturbance of ovarian function may vary from transient amenorrhea to development of premature menopause. The article considers the condition of reproductive function in women with BC: possibility of pregnancy during and after chemotherapy at the background of hormonotherapy and intervals safe for pregnancy. It sets out the results of research of pregnancy and birth in the BC patients. Operative treatment of phase I and phase II of BC may be carried out during any trimester of pregnancy. Modified radical mastectomy is more preferable. It is advisable to refrain from organ-preserving surgical interventions as the radiotherapy of pregnant women shall be suspended till the end of pregnancy. In case of relevant indications, the polychemotherapy may be carried out beginning from trimester II of the pregnancy. The last course of chemotherapy shall be completed at least 4 weeks before the delivery. The chemotherapy is contraindicative during trimester I of the pregnancy, as the teratogenic effect of antineoplastic drugs is very high especially during this period. Hormonotherapy is not recommended today for BC treatment in pregnant women. Tamoxifen exerts strong teratogenic effect and in 20 % of cases leads to impaired development of facial bones and genitourinary system. The article sets out the results of observations children of patients treated by chemotherapy during the pregnancy. Using of assisted reproduction helps to preserve the genetic material in BC patients. Multifollicular ovarian stimulation in patients with hormone-dependent breast cancer, which may entail the potential risk of recurrence, is still quite controversial matter.

Keywords

• рак молочной железы
• беременность
• репродуктивная функция
• гормонотерапия
• полихимиотерапия
• фертиль- ность
• прогноз заболевания
• менопауза
• функция яичников
• пороки развития