Doğer Emek, Calışkan Eray, Mallmann Peter
Department of Obstetrics and Gynecology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Department of Obstetrics and Gynecology, Universitäts-Frauenklinik, Köln, Germany.
J Turk Ger Gynecol Assoc. 2011 Dec 1;12(4):247-55. doi: 10.5152/jtgga.2011.58. eCollection 2011.
Breast cancer is one of the most common cancers diagnosed during pregnancy and its frequency is increasing as more women postpone their pregnancies to their thirties and forties. Breast cancer diagnosis during pregnancy and lactation is difficult and complex both for the patient and doctors. Delay in diagnosis is frequent and treatment modalities are difficult to accept for the pregnant women. The common treatment approach is surgery after diagnosis, chemotherapy after the first trimester and radiotherapy after delivery. Even though early stage breast cancers have similar prognosis, advanced stage breast cancers diagnosed during pregnancy and lactation have poorer prognosis than similar stage breast cancers diagnosed in non-pregnant women. Women who desire to become pregnant after treatment of breast cancer will have many conflicts. Although the most common concern is recurrence of breast cancer due to pregnancy, the studies conducted showed that pregnancy has no negative effect on breast cancer prognosis. In this review we search for the frequency of breast cancer during pregnancy, the histopathological findings, risk factor, diagnostic and treatment modalities. We reviewed the literature for evidence based findings to help consult the patients on the outcome of breast cancer diagnosed during pregnancy and lactation, and also inform the patients who desire to become pregnant after breast cancer according to current evidences.
乳腺癌是孕期最常被诊断出的癌症之一,且随着越来越多的女性将怀孕推迟到三十多岁和四十多岁,其发病率正在上升。孕期和哺乳期的乳腺癌诊断对于患者和医生来说都困难且复杂。诊断延误很常见,而且治疗方式对于孕妇来说也难以接受。常见的治疗方法是诊断后手术,孕早期过后进行化疗,分娩后进行放疗。尽管早期乳腺癌的预后相似,但孕期和哺乳期诊断出的晚期乳腺癌比非孕期女性诊断出的同阶段乳腺癌预后更差。乳腺癌治疗后想要怀孕的女性会面临诸多矛盾。虽然最常见的担忧是怀孕导致乳腺癌复发,但已开展的研究表明,怀孕对乳腺癌预后没有负面影响。在这篇综述中,我们探究孕期乳腺癌的发病率、组织病理学发现、危险因素、诊断和治疗方式。我们查阅文献以获取基于证据的研究结果,从而在乳腺癌诊断于孕期和哺乳期时,帮助向患者提供咨询,告知其相关结果,并依据当前证据,向乳腺癌后想要怀孕的患者提供信息。