Gomez-Hidalgo Natalia R, Mendizabal Elsa, Joigneau Laura, Pintado Pilar, De Leon-Luis Juan
a Department of Obstetrics and Gynecology , Hospital Gregorio Marañon Universidad Complutense de Madrid , Madrid , Spain.
J Obstet Gynaecol. 2019 Jan;39(1):27-35. doi: 10.1080/01443615.2018.1457631. Epub 2018 Jun 18.
To compare the maternal and the perinatal variables of the patients with pregnancy associated breast cancer (PABC) and the pregnant patients without breast cancer (PNABC), we retrospectively included 13 PABC cases and 66.265 PNABC patients. The PABC patients presented a lower mean gestational age at their delivery and had higher induction of labour and prematurity rates. A diagnosis was performed before stage III in 77% of the cases. The overall survival was 90%; moreover, we collected 16 manuscripts when gathering data from 1581 patients with PABC. The mean follow-up time was 70 ± 8 months. The mean maternal age at diagnosis was 34 years old. Most of the patients were at their second trimester of pregnancy. The gestational age at delivery was 35 weeks. A mastectomy was the most frequently used surgical approach. PABC should be managed by a multidisciplinary team, ensuring there is a rigorous oncological treatment, with foetal well-being. IMPACT STATEMENT What is already known on this subject? The malignant breast tumours diagnosed during pregnancy, or 1 year after a delivery are increasing, there is evidence supporting the treatment during a pregnancy with maternal and foetal safety. A PABC should be managed by a multidisciplinary team in a referral centre, ensuring that there is a rigorous oncological treatment with foetal well-being. What do the results of this study add? Our results show that the PABC patients in our centre had a mean maternal age older than the PNABC women, as well as a higher percentage of the induction of labour and prematurity. 48 Cancer was usually diagnosed in early stages, and the most common type was ductal infiltrating, with positive hormonal receptors. For those patients continuing their pregnancies, a mastectomy plus a lymphadenectomy was the most frequent chemotherapy, and was usually administered in the third trimester of pregnancy. What are the implications of these findings for future clinical practice and/or further research? Moreover, the number of publications concerning PABC has grown, series are still scarce. We understand the limitations of the low number of the cases on our population, but this study is the first which compare the PABC with the PNABC patients, allowing to describe and compare the obstetrical and perinatal variables. Finally, we consider it is of a paramount importance to create an international database to register in a prospective way all of the cases of PABC to increase our knowledge in this field.
为比较妊娠相关乳腺癌（PABC）患者与无乳腺癌的妊娠患者（PNABC）的孕产妇及围产期变量，我们回顾性纳入了13例PABC患者和66265例PNABC患者。PABC患者分娩时的平均孕周较低，引产率和早产率较高。77%的病例在III期之前确诊。总生存率为90%；此外，我们在收集1581例PABC患者的数据时收集了16篇文献。平均随访时间为70±8个月。诊断时的平均孕产妇年龄为34岁。大多数患者处于妊娠中期。分娩时的孕周为35周。乳房切除术是最常用的手术方式。PABC应由多学科团队管理，确保进行严格的肿瘤治疗，并保障胎儿健康。影响声明关于该主题已知的内容是什么？孕期或分娩后1年内诊断出的恶性乳腺肿瘤正在增加，有证据支持在孕期进行母婴安全的治疗。PABC应由转诊中心的多学科团队管理，确保进行严格的肿瘤治疗并保障胎儿健康。本研究的结果增加了什么？我们的结果表明，我们中心的PABC患者的平均孕产妇年龄高于PNABC女性，引产率和早产率也更高。48例癌症通常在早期诊断，最常见的类型是导管浸润性癌，激素受体呈阳性。对于那些继续妊娠的患者，乳房切除术加淋巴结清扫术是最常用的化疗方法，通常在妊娠晚期进行。这些发现对未来临床实践和/或进一步研究有何影响？此外，关于PABC的出版物数量有所增加，但病例系列仍然很少。我们理解我们研究人群中病例数量少的局限性，但本研究是首次比较PABC与PNABC患者，从而能够描述和比较产科及围产期变量。最后，我们认为创建一个国际数据库以前瞻性方式登记所有PABC病例对于增加我们在该领域的知识至关重要。
