Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
Breast Cancer Res Treat. 2020 Apr;180(3):695-706. doi: 10.1007/s10549-020-05585-7. Epub 2020 Mar 11.
Breast cancer during pregnancy (BC-P) or the first year post-partum (BC-PP) is rare and whether it differs from breast cancer (BC) in young women not associated with pregnancy is uncertain.
We queried our institutional database for BC-P and BC-PP cases and matched controls with BC not associated with pregnancy diagnosed between January 1, 1985 and December 31, 2013. We performed two parallel retrospective cohort studies evaluating clinico-pathologic features, treatment and outcomes for BC-P and BC-PP cases compared to their controls.
In our population of 65 BC-P cases, 135 controls for BC-P cases, 75 BC-PP cases and 145 controls for BC-PP cases, high grade and estrogen receptor-negativity were more frequent in both case groups than their controls. Among those with stage I-III BC, patterns of local therapy were similar for both case groups and their controls, with the majority undergoing surgery and radiation. Over three-fourths of those with stage I-III BC received chemotherapy. BC-P cases tolerated chemotherapy well, with the majority receiving doxorubicin/cyclophosphamide every 3 weeks. On multivariate analyses of those with stage I-III BC, BC-P cases had non-significantly higher hazards of recurrence and death compared to their controls, while BC-PP cases had non-significantly lower hazards of recurrence and death compared to their controls.
BC-P and BC-PP were associated with adverse clinic-pathologic features in our population. However, we did not observe inferior outcomes for BC-P or BC-PP compared to controls, likely due to receipt of aggressive multi-modality therapy.
妊娠期乳腺癌（BC-P）或产后第一年（BC-PP）较为罕见，其与非妊娠相关的年轻女性乳腺癌（BC）是否存在差异尚不确定。
我们通过机构数据库查询了 BC-P 和 BC-PP 病例，并与 1985 年 1 月 1 日至 2013 年 12 月 31 日期间诊断为非妊娠相关 BC 的对照病例进行了匹配。我们进行了两项平行的回顾性队列研究，以评估 BC-P 和 BC-PP 病例与对照病例的临床病理特征、治疗和结局。
在我们的 65 例 BC-P 病例、135 例 BC-P 病例对照、75 例 BC-PP 病例和 145 例 BC-PP 病例对照中，两组病例的高级别和雌激素受体阴性均较其对照更为常见。在 I-III 期 BC 中，两组病例的局部治疗模式相似，大多数患者接受手术和放疗。超过四分之三的 I-III 期 BC 患者接受了化疗。BC-P 病例对化疗的耐受性良好，大多数患者接受阿霉素/环磷酰胺每 3 周一次的治疗。在对 I-III 期 BC 患者进行的多变量分析中，BC-P 病例的复发和死亡风险与对照相比无显著升高，而 BC-PP 病例的复发和死亡风险与对照相比无显著降低。
在我们的人群中，BC-P 和 BC-PP 与不良的临床病理特征相关。然而，与对照相比，我们并未观察到 BC-P 或 BC-PP 的结局较差，这可能是由于接受了积极的多模式治疗。
