Ishida T, Yokoe T, Kasumi F, Sakamoto G, Makita M, Tominaga T, Simozuma K, Enomoto K, Fujiwara K, Nanasawa T
Second Department of Surgery, Gunma University School of Medicine, Maebashi.
Jpn J Cancer Res. 1992 Nov;83(11):1143-9. doi: 10.1111/j.1349-7006.1992.tb02737.x.
Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation were clarified by means of a case-control study of matched non-pregnant and non-lactating patients with breast cancer. From 18 institutions in Japan, a total of 192 subjects with breast cancer diagnosed during pregnancy (72 cases) and lactation (120 cases) were collected between 1970 and 1988, accounting for 0.76% of all breast cancer patients. The duration of symptoms was longer and tumor size was larger in the study subjects. Although the disease-free interval was longer than that in the control patients, the survival time was shorter. There was no characteristic difference in histologic type. Vascular invasion and lymph node metastasis were found more frequently in the subjects. The positive rates of estrogen receptor and progesterone receptor were lower in the subjects. The 5- and 10-year survival rates of the study patients were 65% and 55%, respectively, and these survivals were significantly lower than those of the control (P < 0.001). The survival rates were poorer in the subjects, in accordance with stage and lymph node metastasis. The results suggest that most of the patients with breast cancer diagnosed during pregnancy and lactation are in a more advanced stage because of a delay in detection and diagnosis, and hence have unfavorable prognosis. Therefore, it is important to diagnose and treat early for improvement of prognosis in patients with breast cancer during pregnancy and lactation.
通过对匹配的非妊娠和非哺乳期乳腺癌患者进行病例对照研究，明确了与妊娠和哺乳相关的乳腺癌患者的临床病理特征及预后情况。在1970年至1988年间，从日本的18家机构收集了总共192例在妊娠期间（72例）和哺乳期（120例）被诊断为乳腺癌的患者，占所有乳腺癌患者的0.76%。研究对象的症状持续时间更长，肿瘤尺寸更大。尽管无病间期比对照患者更长，但生存时间更短。组织学类型无特征性差异。研究对象中血管侵犯和淋巴结转移更为常见。研究对象中雌激素受体和孕激素受体的阳性率更低。研究患者的5年和10年生存率分别为65%和55%，这些生存率显著低于对照组（P<0.001）。根据分期和淋巴结转移情况，研究对象的生存率更差。结果表明，大多数在妊娠和哺乳期被诊断为乳腺癌的患者由于检测和诊断延迟而处于更晚期阶段，因此预后不良。因此，对于妊娠和哺乳期乳腺癌患者，早期诊断和治疗对于改善预后很重要。
