Ulery MaryAnn, Carter Linnette, McFarlin Barbara L, Giurgescu Carmen
MaryAnn Ulery, APN, WHNP-BC, MS, is a women's health nurse practitioner, employed at Woman To Woman Obstetrics and Gynecology, P.C. in Crystal Lake, Illinois.Linnette Carter, APN, CNS, MS, is a perinatal clinical nurse specialist at Rockford Memorial Hospital, Northwestern Illinois Perinatal Network.Barbara L. McFarlin, CNM, RDMS, PhD, is a research assistant professor at the University of Illinois at Chicago College of Nursing.Carmen Giurgescu, RN, WHNP, PhD, is an assistant professor at the University of Illinois at Chicago College of Nursing.
J Midwifery Womens Health. 2009 Sep-Oct;54(5):357-363. doi: 10.1016/j.jmwh.2008.12.007.
Pregnancy-associated breast cancer (PABC) is defined as cancer of the breast diagnosed during pregnancy and up to 1 year postpartum. Delays in diagnosis are frequently associated with increased morbidity and mortality. The aim of this article is to determine the significance of early detection of PABC and to alert health care providers to include PABC in the differential diagnosis when evaluating a breast mass in the perinatal period. This integrative literature review evaluated 15 research studies by using the hypothetical deductive model of clinical reasoning to determine factors related to diagnosis of PABC. As women delay childbearing, the incidence of PABC increases with age. In the reviewed studies, breast cancer was diagnosed with greater frequency in the postpartum period than during any trimester in pregnancy. Delay in diagnosis is complicated by axillary lymph node metastasis, high-grade tumors at diagnosis, and poor outcomes. Early detection is a significant predictor of improved outcomes. Diagnostic modalities such as ultrasound, mammography, and biopsy can be safely used for diagnostic purposes in the evaluation of potential cases of PABC during pregnancy.
妊娠相关乳腺癌（PABC）被定义为在孕期及产后1年内诊断出的乳腺癌。诊断延迟常与发病率和死亡率增加相关。本文的目的是确定早期发现PABC的意义，并提醒医疗保健人员在围产期评估乳腺肿块时，将PABC纳入鉴别诊断。这篇综合文献综述通过使用临床推理的假设演绎模型评估了15项研究，以确定与PABC诊断相关的因素。随着女性生育推迟，PABC的发病率随年龄增长而增加。在纳入综述的研究中，产后诊断出乳腺癌的频率高于孕期的任何一个 trimester。诊断延迟因腋窝淋巴结转移、诊断时的高级别肿瘤以及不良预后而变得复杂。早期发现是改善预后的重要预测因素。超声、乳腺X线摄影和活检等诊断方法可安全地用于孕期潜在PABC病例评估的诊断目的。
