Mignot Laurent
Service d'oncologie et d'hématologie, Hôpital Foch, 40, rue Worth, 92150 Suresnes.
Bull Cancer. 2002 Sep;89(9):772-8.
Breast cancer is the most common cancer in pregnant women occurring in about 1 in 3,000 pregnancies; the engorgement of the breasts in this period may hinder detection of masses and delays in diagnosis are common; this delay, the young age can explain that overall survival of pregnant women is generally worse than in nonpregnant women. In early stage cancer surgery is recommended as the primary treatment; radiation must be avoided during this period but chemotherapy, if considered necessary, specially in late stage disease, may be given after the first trimester without risk of fetal malformation; termination of pregnancy has not been shown to have any beneficial effect but may be considered if maternal treatments are limited by continuation of pregnancy. In contrast, pregnancy in patients with a prior history of breast cancer does not appear compromise the survival of women and no deleterious effects have not been demonstrated in the fetus: if a risk of relapse exists for the breast carcinoma, it's recommended that patients wait two or three years after diagnosis before attempting to conceive.
乳腺癌是孕妇中最常见的癌症,约每3000次妊娠中就有1例发生;此时期乳房的充血可能会妨碍肿块的检测,诊断延迟很常见;这种延迟以及患者年轻,可以解释为什么孕妇的总体生存率通常比非孕妇差。对于早期癌症,建议手术作为主要治疗方法;在此期间必须避免放疗,但如果认为有必要,特别是在晚期疾病中,可在孕早期过后进行化疗,不会有胎儿畸形的风险;终止妊娠尚未显示有任何有益效果,但如果继续妊娠会限制母体治疗,则可考虑终止妊娠。相比之下,有乳腺癌病史的患者怀孕似乎不会影响女性的生存率,也未证明对胎儿有任何有害影响:如果乳腺癌存在复发风险,建议患者在诊断后等待两到三年再尝试怀孕。