Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece.
Breast Care (Basel). 2013 Jun;8(3):203-7. doi: 10.1159/000352093.
Significant controversy exists in the literature regarding the role of pregnancy in the prognosis of breast cancer. We designed a matched case-case study, matching pregnancy-associated breast cancer (PABC) cases with breast cancer cases for stage, age, and year of diagnosis.
39 consecutive cases of PABC were matched with 39 premenopausal cases of breast cancer. Univariate and multivariate survival analyses followed by adjustment for stage, grade, estrogen receptor status, and age at diagnosis, were performed.
Regarding overall survival (OS), univariate analysis pointed to longer OS in non-PABC cases vs. PABC cases. Accordingly, a more advanced stage predicted shorter survival. In the multivariate analysis, the independent aggravating effect mediated by pregnancy persisted. Interestingly, a post hoc nested analysis within PABC cases indicated that the 3rd trimester pointed to shorter OS. The aforementioned results on OS were also replicated during the examination of relapse-free survival.
Implementing a matched case-case design, the present study points to pregnancy as a poor prognostic factor for breast cancer.
关于妊娠在乳腺癌预后中的作用，文献中存在很大争议。我们设计了一项匹配的病例对照研究，将妊娠相关性乳腺癌（PABC）病例与乳腺癌病例按分期、年龄和诊断年份进行匹配。
连续 39 例 PABC 病例与 39 例绝经前乳腺癌病例相匹配。进行单变量和多变量生存分析，并对分期、分级、雌激素受体状态和诊断时的年龄进行调整。
关于总生存（OS），单变量分析表明非 PABC 病例的 OS 长于 PABC 病例。因此，更晚期的分期预示着更短的生存时间。在多变量分析中，妊娠介导的独立加重作用持续存在。有趣的是，在 PABC 病例中进行的事后嵌套分析表明，妊娠晚期（第 3 期）预示着更短的 OS。在检查无复发生存率时，也复制了上述关于 OS 的结果。
通过实施匹配的病例对照设计，本研究指出妊娠是乳腺癌的预后不良因素。
