Department of Surgery, Maimonides Medical Center, Brooklyn, New York.
J Womens Health (Larchmt). 2019 Jun;28(6):778-784. doi: 10.1089/jwh.2018.7264. Epub 2018 Nov 27.
The incidence of pregnancy-associated breast cancer (PABC) increases as more women choose to delay childbearing and the population-based incidence of breast cancer rises. Reliably and safely staging PABC is necessary to choose between starting with local or systemic therapy. With regard to local therapy, both lumpectomy and mastectomy can be considered depending on gestational age and the stage at diagnosis. By mirroring nonpregnant treatment regimens as much as possible, chemotherapy may improve long-term oncologic outcomes while allowing for surgical downstaging during pregnancy. Delaying treatment due to misconceptions regarding risk of local and systemic therapy most certainly worsens oncologic outcomes, and most neonatal morbidity is related to gestational age at delivery and not exposures. Pregnancy itself was once considered an independent risk factor for worse outcome, but the prognosis of these patients is not significantly different than nonpregnant counterparts of a similar age.
妊娠相关性乳腺癌（PABC）的发病率随着越来越多的女性选择延迟生育以及乳腺癌的发病率上升而增加。可靠且安全地对 PABC 进行分期，对于选择局部治疗还是全身治疗至关重要。关于局部治疗，可根据妊娠年龄和诊断时的分期选择保乳术或乳房切除术。通过尽可能地模仿非妊娠治疗方案，化疗可能会改善长期肿瘤学结果，同时在怀孕期间进行手术降期。由于对局部和全身治疗风险的误解而延迟治疗，肯定会使肿瘤学结果恶化，而且大多数新生儿发病率与分娩时的胎龄有关，而与暴露无关。怀孕本身曾被认为是预后更差的独立危险因素，但这些患者的预后与年龄相仿的非妊娠患者并无显著差异。
