Treatment of metastatic breast cancer with trastuzumab and vinorelbine during pregnancy.

The management of breast cancer during pregnancy is a crucial clinical issue. It is important to evaluate the impact of chemotherapy on a woman and her fetus. Studies from our institution have demonstrated the safety and efficacy of treating women with adjuvant 5-fluorouracil/doxorubicin/cyclophosphamide during the second or third trimester of pregnancy. However, the literature regarding the treatment of metastatic breast cancer in a pregnant patient is scarce. In this article, we describe the successful treatment of a woman at 27 weeks of pregnancy with recurrent HER2/neu-overexpressing breast cancer who was symptomatic from multiple liver metastases. Per our review of the literature and to our knowledge, she is the first patient to be treated with weekly vinorelbine plus trastuzumab. Our patient had near complete resolution of her disease and delivered a healthy male infant at 34 weeks of gestation.