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Trastuzumab use during pregnancy: long-term survival after locally advanced breast cancer and long-term infant follow-up

Andrade, Jurandyr M. de; Brito, Luiz G.O.; Moises, Elaine C.D.; Amorim, Andréa C.; Rapatoni, Liane; Carrara, Hélio H.A.; Tiezzi, Daniel G.

doi: 10.1097/CAD.0000000000000344

Here, we describe the case of a patient diagnosed with locally advanced breast cancer 8 years ago. Her treatment course was neoadjuvant chemotherapy, followed by mastectomy and then adjuvant radiotherapy and trastuzumab (TTZ). During the use of adjuvant targeted therapy, an incidental pregnancy was diagnosed. Four years later, she developed bone and cerebral metastases, and since then, she has received courses of TTZ, capecitabine, lapatinib, and radiotherapy with intermittent control of the disease. Her 7-year-old son presents a normal physical and long-term neurological developmental curve according to specialized evaluation. This case is unique for several reasons: the patient received the highest dose of TTZ yet described during pregnancy (4400 mg); there has been a long period of disease-free survival after treatment for locally advanced breast cancer and long overall survival despite successive disease progressions during the metastatic phase of the disease (97 months), and there was a monitored pediatric follow-up period (7 years).

aDepartment of Gynecology and Obstetrics, Gynecological Oncology and Breast Disease Division

bDepartment of Gynecology and Obstetrics, Gynecological Surgery Division

cDepartment of Obstetrics and Gynecology, Obstetrics Division

dDepartment of Internal Medicine, Clinical Oncology Division

eDepartment of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil

Correspondence to Jurandyr M. de Andrade, MD, PhD, Avenida Bandeirantes, 3900, 8th Floor, Ribeirão Preto 14049-900, São Paulo, Brazil Tel: +55 16 3602 2589; fax: +55 16 3602 1524; e-mail:

Received September 20, 2015

Accepted December 27, 2015

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