由于妊娠期和围产期可能诊断出乳腺癌，故胎儿或新生儿可能接触化疗，这是母亲和临床医师关切的问题之一。紫杉醇是常用的乳腺癌化疗药物之一，不过关于其母乳排出量研究极少。由于可能存在新生儿接触化疗药物的风险，故传统通常禁止化疗期间进行母乳喂养，但是数据有限。
2019年7月31日，英国癌症研究基金会、英国《自然》旗下《英国癌症杂志》在线发表新西兰奥塔哥大学、南方血液与癌症中心、天顶科技的临床病例研究报告，探讨了乳腺癌女性接受紫杉醇静脉化疗后的母乳排出量。
该临床病例研究对一例妊娠期间诊断为早期乳腺癌接受紫杉醇每周每平方米体表面积80毫克治疗的33岁女性患者血清和母乳紫杉醇浓度进行测量。
结果发现，紫杉醇化疗72小时后，母乳紫杉醇浓度降至可量化最低剂量以下，相对婴儿剂量为0.091%。
因此，该研究结果表明，静脉注射紫杉醇每平方米体表面积80毫克剂量72小时后，母乳排出量可以忽略不计，可能是接触紫杉醇后重新开始母乳喂养的安全时间，故有必要开展进一步研究。
Br J Cancer. 2019 Jul 31. [Epub ahead of print]
Breast milk paclitaxel excretion following intravenous chemotherapy—a case report.
Christopher G. C. A. Jackson, Tessa Morris, Noelyn Hung, Tak Hung.
University of Otago, Dunedin, New Zealand; Southern Blood and Cancer Service, Dunedin, New Zealand; Zenith Technology Corporation Limited, Dunedin, New Zealand.
Breast cancer can be diagnosed during pregnancy and in the peri-partum period, and the potential exposure of a foetus or neonate to chemotherapy is of concern to mothers and clinicians. Paclitaxel is a commonly used agent in breast cancer, but little is known about its excretion in breast milk. Breastfeeding during chemotherapy has been traditionally cautioned against due to the risk of neonatal exposure to chemotherapy agents, however, data are limited. We measured serum and breast milk concentrations of paclitaxel in a 33-year-old woman with an early breast cancer diagnosed during pregnancy and treated with weekly paclitaxel 80 mg/m2. We found breast milk paclitaxel levels drop below the minimum quantifiable dose at 72 h following chemotherapy, with a relative infant dose of 0.091%. Breast milk excretion of paclitaxel following a dose of 80 mg/m2 is negligible at 72 h, and this may be a safe time to recommence breastfeeding following exposure.
DOI: 10.1038/s41416-019-0529-z
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