RESUMO
Results of clinical and experimental research into various aspects of cancer and pregnancy are reported. These investigations have been proceeding for many years. 845 cases of pregnancy with concomitant malignant tumor at various localization are reported here. Diagnostic methods and results of treating cervical and breast cancer during pregnancy are described. Also discussed is the influence of pregnancy on the clinical course of cancer and survival. Fertility after recovery from cancer accomplished by means of organ-preserving surgery is commented on.
PIP: This study describes the patterns of cervical and breast cancer among pregnant mothers who were treated at the NN Petrov Institute of Oncology in Russia during 1960-94. The sample included 476 patients admitted with invasive cervical cancer that was diagnosed during pregnancy or after birth or abortion. Findings were compared to a control group of 640 invasive cervical cancer patients and 240 breast cancer patients of reproductive age. 95.3% of cancers were malignant. 60.9% were tumors of the cervix, breast, and ovaries. The percentage of cervical cancer cases was 23.5% of reproductive age women. In 69% of the cervical cancer patients, the depth of tumor growth into the stroma exceeded 1 cm compared to only 32% in the control group. Cervical stage I cancer during pregnancy spread to the regional lymph nodes twice as frequently as in the control group. Lymphatic metastases were greatest in patients with regional metastases during the second and third trimester or after birth. 21.4% of pregnant patients and 15.5% of nonpregnant patients had stage III cervical cancer. 5-year survival rates after prompt treatment was 58.4% compared to 78.8% for controls. 2% of breast cancer patients were pregnant at the time of diagnosis, and most had the lobular form. Regional metastases were 1.5-2.0 times higher for breast cancer cases diagnosed during pregnancy compared to nonpregnant cases. The cancers diagnosed in the last two trimesters or during breast feeding tend to be aggravated. The 5-year survival rate is poor. The prognosis for the fetus is better if diagnosed in the third trimester, but better for the mother if diagnosed in the first trimester. Pregnancy does not increase the risk of malignant tumors and is not likely to accelerate tumor growth. IUD contraception should be used by breast cancer patients post-treatment. Cervical cancer patients should begin contraceptive use about 2 years after favorable prognosis.
