Patterns of care over 10 years in young breast cancer patients in the Netherlands, a nationwide population-based study

Maliko, Nansi; Bijker, Nina; Bos, Monique EMM.; Wouters, Michel W. J. M.; Peeters, Marie-Jeanne TFD. Vrancken

doi:10.1016/j.breast.2022.11.002

Cited by 6 publications

(1 citation statement)

References 39 publications

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“…The incidence of PrBC is likely to increase, presumably due to the trend of women becoming pregnant at an older age and breast cancer prevalence increasing with age [ 7 , 8 ]. Breast cancer during pregnancy is frequently diagnosed during the third trimester and often is a high-grade tumor with an aggressive clinical subtype [ 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The treatment of PrBC requires a multidisciplinary approach to determine the best diagnostic and therapeutic strategy for both maternal and fetal health [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Safe Use of 125I-Seeds as a Localization Technique in Breast Cancer during Pregnancy

Heeling,

van de Kamer,

Methorst

et al. 2023

Cancers

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Introduction: Some aspects of the treatment protocol for breast cancer during pregnancy (PrBC) have not been thoroughly studied. This study provides clarity regarding the safety of the use of 125I-seeds as a localization technique for breast-conserving surgery in patients with PrBC. Methods: To calculate the exposure to the fetus of one 125I-seed implanted in a breast tumor, we developed a model accounting for the decaying 125I-source, time to surgery, and the declining distance between the 125I-seed and the fetus. The primary outcome was the maximum cumulative fetal dose of radiation at consecutive gestational ages (GA). Results: The cumulative fetal dose remains below 1 mSv if a single 125I-seed is implanted at a GA of 26 weeks. After a GA of 26 weeks, the fetal dose can be at a maximum of 11.6 mSv. If surgery takes place within two weeks of implantation from a GA of 26 weeks, and one week above a GA of 32 weeks, the dose remains below 1 mSv. Conclusion: The use of 125I-seeds is safe in PrBC. The maximum fetal exposure remains well below the threshold of 100 mSv, and therefore, does not lead to an increased risk of fetal tissue damage. Still, we propose keeping the fetal dose as low as possible, preferably below 1 mSv.

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