Beadle Beth M, Woodward Wendy A, Middleton Lavinia P, Tereffe Welela, Strom Eric A, Litton Jennifer K, Meric-Bernstam Funda, Theriault Richard L, Buchholz Thomas A, Perkins George H
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2009 Mar 15;115(6):1174-84. doi: 10.1002/cncr.24165.
Some evidence suggests that women with pregnancy-associated breast cancers (PABC) have a worse outcome compared with historical controls. However, young age is a worse prognostic factor independently, and women with PABC tend to be young. The purpose of the current study was to compare locoregional recurrence (LRR), distant metastases (DM), and overall survival (OS) in young patients with PABC and non-PABC.
Data for 668 breast cancers in 652 patients aged<or=35 years were retrospectively reviewed. One hundred four breast cancers (15.6%) were pregnancy-associated; 51 cancers developed during pregnancy and 53 within 1 year after pregnancy.
The median follow-up for all living patients was 114 months. Patients who developed PABC had more advanced T classification, N classification, and stage group (all P<.04) compared with patients with non-PABC. Patients with PABC had no statistically significant differences in 10-year rates of LRR (23.4% vs 19.2%; P=.47), DM (45.1% vs 38.9%; P=.40), or OS (64.6% vs 64.8%; P=.60) compared with patients with non-PABC. For those patients who developed breast cancer during pregnancy, any treatment intervention during pregnancy provided a trend toward improved OS compared with delaying evaluation and treatment until after delivery (78.7% vs 44.7%; P=.068).
Young patients with PABC had no statistically significant differences in LRR, DM, or OS compared with those with non-PABC; however, pregnancy contributed to a delay in breast cancer diagnosis, evaluation, and treatment. Primary care and reproductive physicians should be aggressive in the workup of breast symptoms in the pregnant population to expedite diagnosis and allow multidisciplinary treatment.
一些证据表明，与历史对照相比，妊娠相关乳腺癌（PABC）女性的预后较差。然而，年轻是一个独立的不良预后因素，且PABC女性往往较为年轻。本研究的目的是比较年轻PABC患者和非PABC患者的局部区域复发（LRR）、远处转移（DM）及总生存期（OS）。
回顾性分析了652例年龄≤35岁患者的668例乳腺癌数据。104例乳腺癌（15.6%）与妊娠相关；51例在妊娠期间发生，53例在妊娠后1年内发生。
所有存活患者的中位随访时间为114个月。与非PABC患者相比，发生PABC的患者T分类、N分类及分期组更晚（均P<0.04）。PABC患者与非PABC患者相比，10年LRR率（23.4%对19.2%；P = 0.47）、DM率（45.1%对38.9%；P = 0.40）或OS率（64.6%对64.8%；P = 0.60）无统计学显著差异。对于那些在妊娠期间发生乳腺癌的患者，与延迟评估和治疗至分娩后相比，妊娠期间的任何治疗干预均有改善OS的趋势（78.7%对44.7%；P = 0.068）。
年轻PABC患者与非PABC患者相比，LRR、DM或OS无统计学显著差异；然而，妊娠导致乳腺癌诊断、评估和治疗延迟。初级保健医生和生殖科医生应积极检查孕妇的乳房症状，以加快诊断并实现多学科治疗。
