妊娠期乳腺癌的临床特征和预后：腔面 B 型亚型的生存状况较差。

Clinical Characteristics and Prognosis of Pregnancy-Associated Breast Cancer: Poor Survival of Luminal B Subtype.

机构信息

Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Oncology. 2018;95(3):163-169. doi: 10.1159/000488944. Epub 2018 Jun 18.

DOI:10.1159/000488944

PMID:29913459

Abstract

BACKGROUND

Pregnancy-associated breast cancer (PABC) is rare and is generally defined as breast cancer diagnosed during pregnancy or within 1 year of delivery. The average ages of marriage and childbearing are increasing, and PABC is expected to also increase. This study is intended to increase understanding of the characteristics of PABC.

METHODS

A database of 2,810 patients with breast cancer diagnosed when they were less than 40 years of age was reviewed. The clinicopathological factors and survival of PABC (40 patients) were compared to those of patients with young breast cancer (YBC, non-pregnant or over 12 months after delivery; 2,770 patients).

RESULTS

PABC had significantly lower estrogen receptor (ER) and progesterone receptor (PR) expression (ER-positive 50.0%, PR-positive 45.0%) and higher HER2 overexpression (38.5%) than YBC. The most common subtype of PABC was triple-negative breast cancer (TNBC; 35.9%), and luminal A subtype represented only 7.7% of cases. In univariate analysis, PABC had significantly worse disease-free survival (DFS) and breast cancer-specific survival (BCSS) compared to YBC. In multivariate analysis, PABC was associated with worse BCSS (HR 4.0, 95% CI 1.2-12.9, p = 0.019) and survival, but there was no difference in DFS between PABC and YBC. In subgroup analysis by subtype, luminal B subtype of PABC showed worse DFS (HR 3.5; 95% CI 1.1-11.2, p = 0.039) and BCSS (HR 10.2, 95% CI 1.2-87.1, p = 0.035), especially with high Ki67. However, no differences were demonstrated in other subtypes.

CONCLUSION

In this study, PABC showed lower expression of ER/PR, higher overexpression of HER2, fewer luminal A subtype, and more TNBC subtype compared to YBC. PABC had worse BCSS, especially luminal B subtype, compared to YBC.

摘要

背景

妊娠相关性乳腺癌（PABC）较为罕见，通常定义为在妊娠期间或分娩后 1 年内诊断出的乳腺癌。人们的结婚和生育年龄逐渐增加，预计 PABC 也会随之增加。本研究旨在提高对 PABC 特征的认识。

方法

回顾了一个数据库，其中包含 2810 名年龄小于 40 岁的乳腺癌患者的临床病理资料。将 PABC（40 例）的临床病理特征和生存情况与年轻乳腺癌患者（非妊娠或分娩后 12 个月以上；2770 例）进行比较。

结果

与 YBC 相比，PABC 的雌激素受体（ER）和孕激素受体（PR）表达明显更低（ER 阳性率 50.0%，PR 阳性率 45.0%），HER2 过表达率更高（38.5%）。PABC 最常见的亚型是三阴性乳腺癌（TNBC；35.9%），而 luminal A 型仅占 7.7%。单因素分析显示，PABC 的无病生存（DFS）和乳腺癌特异性生存（BCSS）明显较 YBC 差。多因素分析显示，PABC 与 BCSS 较差相关（HR 4.0，95%CI 1.2-12.9，p = 0.019）和生存情况相关，但 PABC 与 YBC 之间在 DFS 方面无差异。在根据亚型进行的亚组分析中，PABC 的 luminal B 亚型显示出更差的 DFS（HR 3.5；95%CI 1.1-11.2，p = 0.039）和 BCSS（HR 10.2，95%CI 1.2-87.1，p = 0.035），尤其是 Ki67 高表达的患者。然而，其他亚型并未表现出差异。