Simionescu Anca A, Horobeț Alexandra, Belaşcu Lucian, Median Dragoş Mircea
Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Filantropia Clinical Hospital,011171, Bucharest, Romania.
Department of International Business and Economics, The Bucharest University of Economic Studies, 010374, Bucharest, Romania.
Medicina (Kaunas). 2020 Oct 6;56(10):522. doi: 10.3390/medicina56100522.
Breast cancer is among the most common cancer types encountered during pregnancy. Here, we aimed to describe the characteristics, management, and outcomes of women with pregnancy-associated breast cancer at a tertiary-level hospital in Romania. We retrospectively and prospectively collected demographic, oncological, and obstetrical data for women diagnosed with cancer during pregnancy, and who elected to continue their pregnancy, between June 2012 and June 2020. Complete data were obtained regarding family and personal medical history and risks factors, cancer diagnosis and staging, clinical and pathological features (including histology and immunohistochemistry), multimodal cancer treatment, pregnancy management (fetal ultrasounds, childbirth, and postpartum data), and infant development and clinical evolution up to 2020. Cancer therapy was administered following national guidelines and institutional protocols and regimens developed for non-pregnant patients, including surgery and chemotherapy, while avoiding radiotherapy during pregnancy. At diagnosis, 16.67% of patients were in an advanced/metastatic stage, while 75% were in early operable stages. However, the latter patients underwent neoadjuvant chemotherapy rather than up-front surgery due to aggressive tumor biology (triple negative, multifocal, or HER2+). No patient achieved complete pathological remission, but only one patient relapsed. No recurrence was recorded within 12 months among early-stage patients. In this contemporary assessment of real-world treatment patterns and outcomes among patients with pregnancy-associated breast cancer, our findings were generally consistent with globally observed treatment outcomes, underscoring the need for a multidisciplinary team and reference centers.
乳腺癌是孕期最常见的癌症类型之一。在此，我们旨在描述罗马尼亚一家三级医院中妊娠相关乳腺癌女性患者的特征、治疗及预后情况。我们回顾性和前瞻性地收集了2012年6月至2020年6月期间孕期被诊断为癌症且选择继续妊娠的女性的人口统计学、肿瘤学及产科数据。获取了关于家族和个人病史及危险因素、癌症诊断和分期、临床和病理特征（包括组织学和免疫组化）、多模式癌症治疗、妊娠管理（胎儿超声检查、分娩及产后数据）以及截至2020年婴儿发育和临床进展的完整数据。癌症治疗遵循国家指南以及为非妊娠患者制定的机构方案和治疗方案，包括手术和化疗，同时避免孕期放疗。诊断时，16.67%的患者处于晚期/转移期，而75%处于早期可手术阶段。然而，由于肿瘤生物学行为侵袭性强（三阴性、多灶性或HER2阳性），后一组患者接受了新辅助化疗而非直接手术。没有患者达到完全病理缓解，但只有一名患者复发。早期患者在12个月内未记录到复发情况。在对妊娠相关乳腺癌患者的现实世界治疗模式和预后的当代评估中，我们的发现总体上与全球观察到的治疗结果一致，强调了多学科团队和参考中心的必要性。
