Epirubicin for breast cancer during pregnancy: a case report

BACKGROUND: The rarity of breast cancer in pregnancy and conflict between the optimal maternal therapy and fetal risks make its management challenging. Chemotherapy is the standard treatment for advanced cases. Epirubicin as a combination agent has been reported for breast and other cancers in pregnancy but not as a single agent. We report a case of advanced breast cancer treated with epirubicin neoadjuvant chemotherapy in pregnancy. CASE: A 30-year-old primigravida with multifocal, grade 3 invasive ductal carcinoma, stage T2 N1M0, received 4 cycles of primary epirubicin chemotherapy in pregnancy from 23 weeks' gestation. The chemotherapy was well tolerated by the mother and fetus, and a good response was achieved prior to postnatal combination chemotherapy and definitive surgery. CONCLUSION: Epirubicin chemotherapy appears safe and effective in pregnancy.