Department of Surgical Sciences, University of Insubria, Varese, Italy.
Breast J. 2010 Sep-Oct;16 Suppl 1:S22-5. doi: 10.1111/j.1524-4741.2010.00998.x.
Pregnancy-related breast cancer (PBC) is one of the most common malignancies during pregnancy (approx. one in 3,000 pregnancies); up to 3% of breast cancers are diagnosed in pregnancy. As maternal age at the time of pregnancy continues to increase as the incidence of breast cancer, the incidence of PBC is expected to increase. A review of the literature was performed in order to identify optimal treatment strategies. Most of the data surrounding the diagnosis and treatment PBC is small cohort studies, and there are no randomized controlled trials. Diagnostic delays are common. Preoperative histologic confirmation is required. Conservative surgery can be proposed at the end of second and third trimester, and radiotherapy is delayed after childbirth. The safety of sentinel lymph node biopsy has yet to be confirmed, and the axillary dissection is the traditional treatment of choice. The chemotherapeutic agents utilized are the same as those used in non-pregnant patients, but they should not be administered in the first trimester. Radiotherapy and endocrine therapy are recommended to be avoided during pregnancy. The treatment of PBC is multidisciplinary and necessitates active communication among the patient, obstetrician, medical, surgical, and radiation oncologists. Diagnosis is often delayed because of physiologic changes of the breast; obstetricians should perform a thorough breast examination at the first prenatal visit and maintain a high index of suspicion for cancer. Other therapies may need to be considered, although their usage now is not currently recommended owing to the paucity of safety data.
妊娠相关性乳腺癌（PBC）是妊娠期间最常见的恶性肿瘤之一（约每 3000 例妊娠中出现 1 例）；高达 3%的乳腺癌在妊娠期间被诊断。由于孕妇年龄的增加与乳腺癌的发病率同步上升，预计 PBC 的发病率将会上升。为了确定最佳的治疗策略，我们对文献进行了回顾。大多数关于 PBC 的诊断和治疗的数据都是小队列研究，没有随机对照试验。诊断延迟很常见。需要术前组织学确认。在孕晚期（第二和第三孕期）可以提出保守手术，分娩后延迟放疗。前哨淋巴结活检的安全性尚未得到证实，腋窝解剖是传统的治疗选择。所用的化疗药物与非妊娠患者相同，但不应在孕早期使用。建议避免在怀孕期间进行放疗和内分泌治疗。PBC 的治疗是多学科的，需要患者、产科医生、内科医生、外科医生和放射肿瘤学家之间的积极沟通。由于乳房的生理变化，诊断常常被延迟；妇产科医生应在首次产前检查时进行彻底的乳房检查，并对癌症保持高度警惕。可能需要考虑其他治疗方法，尽管由于安全性数据有限，目前不推荐使用这些方法。
