TAC Chemotherapy during the First Trimester of pregnancy The First Case Report

N. Ibrahim, A. Saadeddin, T. Al Sabbagh Riyadh Military Hospital, Saudi Arabia

Objective :
Animal studies have shown that docetaxel is embryotoxic and fetotoxic ; but the effect of exposure to docetaxel containing regimens during pregnancy in humans is not known.

Method/treatment :
The records of all female patients with breast cancer treated with docetaxel including regimens were reviewed. We report the experience of one case of pregnancy for a 38 years old Saudi female who presented with locally advanced left sided breast cancer ; stage T4b N1 M0, G3, hormone receptor negative infiltrating ductal carcinoma. She was treated with neoadjuvant chemotherapy TAC regimen. But surprisingly she was discovered to be 16 weeks pregnant just after completion of 4th cycle of TAC regimen.

Results :
TAC regimen was discontinued immediately after recognition of pregnancy. Subsequently she had Modified Radical Mastectomy and axillary dissection followed by 2 cycles of AC chemotherapy. At 32 weeks of pregnancy, an emergency caesarean section was done and the outcome was a healthy baby boy, whose birth weight and Apgar score were within normal limits with no anomalies.

Conclusion :
Although fetal exposure to docetaxel including chemotherapeutic regimen during the first trimester of pregnancy did not show abnormalities, there is no assurance that deleterious fetal effects will not occur. Patients receiving chemotherapy should be advised to practice adequate contraception.

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