Molckovsky Andrea, Madarnas Yolanda
Department of Oncology, Queen's University, Kingston, ON, Canada.
Breast Cancer Res Treat. 2008 Apr;108(3):333-8. doi: 10.1007/s10549-007-9616-6. Epub 2007 May 26.
Breast cancer in pregnancy is a clinically challenging situation for patients and their physicians. A review of the literature was performed to help identify optimal treatment strategies.
A Medline search between 1966 to the present using the keywords "breast", "carcinoma", and "pregnancy" revealed numerous hits, from which English-language articles including epidemiologic studies, case series, and general summaries were reviewed.
There is a paucity of prospective studies regarding diagnosis and treatment of breast cancer in pregnancy due to its rarity. However a general review of the literature database reveals that women diagnosed with breast cancer during pregnancy have similar disease characteristics to age-matched controls. Surgery remains the mainstay of treatment of breast cancer during pregnancy, and in some circumstances breast-conserving surgery is an acceptable option. Adjuvant treatment can proceed with some modifications that minimize harm to the fetus, namely limiting radiation exposure and timing chemotherapy properly. Post-partum decisions regarding lactation and future fertility should be addressed on a per-patient basis.
Breast cancer in pregnancy is an uncommon phenomenon but one which poses dilemmas for patients and their physicians. A multi-disciplinary approach is recommended for optimal clinical-decision making.
妊娠合并乳腺癌对患者及其医生来说是一种具有临床挑战性的情况。进行文献综述以帮助确定最佳治疗策略。
使用关键词“乳腺”“癌”和“妊娠”在1966年至当前进行的Medline搜索显示了大量结果，从中对包括流行病学研究、病例系列和综述在内的英文文章进行了回顾。
由于妊娠合并乳腺癌罕见，关于其诊断和治疗的前瞻性研究较少。然而，对文献数据库的综合回顾显示，孕期被诊断为乳腺癌的女性与年龄匹配的对照组具有相似的疾病特征。手术仍然是妊娠合并乳腺癌治疗的主要手段，在某些情况下，保乳手术是一个可接受的选择。辅助治疗可以进行一些调整，以尽量减少对胎儿的伤害，即限制辐射暴露并合理安排化疗时间。产后关于哺乳和未来生育能力的决定应根据每个患者的情况来处理。
妊娠合并乳腺癌是一种罕见现象，但它给患者及其医生带来了两难境地。建议采用多学科方法进行最佳临床决策。
