Department of Breast Surgery, Fudan University Shanghai Cancer Center, Fudan University, 270 Dong-an Rd, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
BMC Cancer. 2020 Mar 23;20(1):244. doi: 10.1186/s12885-020-06724-5.
Pregnancy-associated breast cancer (PABC) is an aggressive disease, and since Chinese authority began to encourage childbearing in 2015, the incidence of PABC has increased. This study investigated the characteristics and survival of PABC patients.
Patients with PABC who underwent surgery at Fudan University, Shanghai Cancer Center between 2005 and 2018 were enrolled. Data concerning the tumor characteristics, maternal state (whether first or non-first pregnancy) and survival outcome were recorded. Pearson Chi-square tests were used to compare the characteristics of the tumors, and Kaplan-Meier methods were used to perform the survival analysis.
Overall, 203 PABC patients were recruited. Since 2015, 65.5% of non-first pregnant women were diagnosed with breast cancer, it's 5.7 fold of the incidence of PABC in non-first pregnant women. No significant differences in tumor characteristics were observed between the patients who were in their first pregnancy and those in non-first pregnancy. Among the entire PABC population, luminal B breast cancer accounted for the largest proportion (38.4%), followed by triple-negative breast cancer (TNBC, 30.0%). The distribution of the molecular subtypes of PABC and non-PABC differed (P < 0.001) as follows: in the PABC patients, Luminal B 38.4%, Triple negative breast cancer (TNBC) 30.1%, Human Epidermal Growth Factor Receptor 2 (HER-2) overexpression 15.8%, and Luminal A 10.8%; in the non-PABC patients, Luminal A 50.9%, Luminal B 20.1%, TNBC 17.4%, and HER-2 overexpression 8.0%. The 3-year disease free survival (DFS) of all PABC patients was 80.3%. The 3-year DFS of the patients in the first-pregnancy group was 78.4%, and that of the patients in the non-first-pregnancy group was 83.7% (P = 0.325).
Our study proved that the proportion of women who developed PABC during the second or third pregnancy was extremely high relative to the newborn populations. The patients in the PABC population tended to present more luminal B and TNBC breast cancer than the non-PABC patients.
妊娠相关性乳腺癌（PABC）是一种侵袭性疾病，自 2015 年中国开始鼓励生育以来，PABC 的发病率有所增加。本研究调查了 PABC 患者的特征和生存情况。
纳入 2005 年至 2018 年在复旦大学上海癌症中心接受手术治疗的 PABC 患者。记录肿瘤特征、产妇状态（首次妊娠或非首次妊娠）和生存结局数据。采用 Pearson Chi-square 检验比较肿瘤特征，采用 Kaplan-Meier 法进行生存分析。
共纳入 203 例 PABC 患者。自 2015 年以来，65.5%的非首次妊娠妇女被诊断为乳腺癌，其 PABC 发病率是非首次妊娠妇女的 5.7 倍。首次妊娠和非首次妊娠患者的肿瘤特征无显著差异。在所有 PABC 患者中，Luminal B 型乳腺癌占比最大（38.4%），其次是三阴性乳腺癌（TNBC，30.0%）。PABC 和非 PABC 患者的分子亚型分布不同（P<0.001）：在 PABC 患者中，Luminal B 型占 38.4%，三阴性乳腺癌（TNBC）占 30.1%，人表皮生长因子受体 2（HER-2）过表达占 15.8%，Luminal A 型占 10.8%；在非 PABC 患者中，Luminal A 型占 50.9%，Luminal B 型占 20.1%，TNBC 占 17.4%，HER-2 过表达占 8.0%。所有 PABC 患者的 3 年无病生存率（DFS）为 80.3%。首次妊娠组患者的 3 年 DFS 为 78.4%，非首次妊娠组患者的 3 年 DFS 为 83.7%（P=0.325）。
本研究证实，在二胎或三胎生育期发生 PABC 的女性比例相对于新生儿人群极高。PABC 患者倾向于表现出更多的 Luminal B 和 TNBC 乳腺癌，而非 PABC 患者。
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