Reyes Eduardo, Xercavins Natalia, Saura Cristina, Espinosa-Bravo Martin, Gil-Moreno Antonio, Cordoba Octavi
Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Vall d'Hebron Breast Cancer Center, Service of Oncology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Tumori. 2020 Oct;106(5):378-387. doi: 10.1177/0300891620925158. Epub 2020 Jul 6.
Breast cancer is one of the most frequently occurring cancers during pregnancy and its incidence is increasing. Many studies have shown poor outcomes, the causes of which remain unclear.
To analyze radiologic characteristics, histology, and prognosis factors of breast cancer during pregnancy.
A total of 42 patients with breast cancer diagnosed during pregnancy (BCP) were matched with 84 patients with breast cancer of similar age who were not pregnant. Sensitivity of radiology, tumor characteristics, prognosis factors, disease-free survival, and overall survival were analyzed.
The sensitivity of breast ultrasound was higher than that of mammography for both groups. Ultrasound sensitivity for cancer was 95.7% in patients with BCP versus 98% in the not pregnant group, with non-statistically significant differences. Mammography sensitivity for cancer was 56.5% in patients with BCP versus 61% in the not pregnant group, with non-statistically significant differences. The stage at diagnosis according to the TNM staging system was significantly higher in patients with BCP with stage IV cancer: 16.7% in patients with BCP versus 3.7% in the not pregnant group ( = 0.03). No statistically significant differences were observed in histologic grade, Ki-67 index, or molecular subtype. Disease-free survival and overall survival were significantly lower in patients with BCP ( = 0.002 and = 0.04). Multivariate analysis showed no difference when adjusting for stage and surrogate molecular subtype.
Breast ultrasound shows a high sensitivity to detect breast cancer during pregnancy. BCP is diagnosed at a higher stage than in nonpregnant women. In our series, patients with BCP had poorer outcomes than the not pregnant group. These results were not observed when adjusting for stage.
乳腺癌是孕期最常见的癌症之一，其发病率正在上升。许多研究表明预后较差，但其原因尚不清楚。
分析孕期乳腺癌的放射学特征、组织学和预后因素。
共有42例孕期诊断为乳腺癌（BCP）的患者与84例年龄相仿的非孕期乳腺癌患者进行匹配。分析放射学敏感性、肿瘤特征、预后因素、无病生存期和总生存期。
两组中乳腺超声的敏感性均高于乳腺X线摄影。BCP患者中癌症的超声敏感性为95.7%，非孕期组为98%，差异无统计学意义。BCP患者中癌症的乳腺X线摄影敏感性为56.5%，非孕期组为61%，差异无统计学意义。根据TNM分期系统，BCP患者中IV期癌症的诊断分期显著更高：BCP患者中为16.7%，非孕期组为3.7%（P = 0.03）。在组织学分级、Ki-67指数或分子亚型方面未观察到统计学显著差异。BCP患者的无病生存期和总生存期显著更低（P = 0.002和P = 0.04）。多因素分析在调整分期和替代分子亚型后未显示差异。
乳腺超声在孕期检测乳腺癌时显示出高敏感性。BCP的诊断分期高于非孕期女性。在我们的系列研究中，BCP患者的预后比非孕期组差。调整分期后未观察到这些结果。
