Li Yang, Zhang Yuhan, Wang Shuaibing, Lu Su, Song Yixuan, Liu Hong
The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.
Oncology Department, China National Petroleum Corporation Central Hospital, Langfang, Hebei Province, 065000, People's Republic of China.
Cancer Manag Res. 2021 Feb 15;13:1505-1515. doi: 10.2147/CMAR.S290566. eCollection 2021.
We aimed to examine the effect of pregnancy on prognosis in young breast cancer (YBC) patients with hormone receptor (HR) positive after surgery and the safety of interrupting endocrine therapy (ET).
A retrospective cohort study was performed in patients who became pregnant after BC surgery under the age of 35 and were matched (1:4) to nonpregnant patients from 2006 to 2014. The primary endpoints were disease-free survival (DFS) and overall survival (OS) in HR-positive BC patients, and the secondary endpoints were DFS and OS in HR-negative BC patients and the whole population. Subgroup analyses included the DFS of patients who became pregnant within 5 years after surgery and DFS according to the ET interval time (≤ 30 months v > 30 months) in the pregnant group.
A total of 1323 YBC patients were collected in our study, which included 68 pregnant patients and 264 matched nonpregnant patients. There were no statistically significant differences in DFS and OS among HR-positive patients (P=0.657, P=0.250, respectively) and the whole population (P=0.058, P=0.152, respectively). A BC pregnancy interval ≤ 5 years showed a better DFS (P=0.042), and an ET interval ≤ 30 months had a worse DFS (P = 0.01).
This study did not observe a worse prognosis in patients with HR-positive disease who became pregnant after BC surgery, and an ET interval less than 30 months in pregnant patients led to a worse outcome. Patients were able to become pregnant within 5 years after surgery.
我们旨在研究妊娠对激素受体(HR)阳性的年轻乳腺癌(YBC)患者术后预后的影响以及中断内分泌治疗(ET)的安全性。
对2006年至2014年间35岁以下乳腺癌手术后怀孕的患者进行回顾性队列研究,并与未怀孕患者按1:4进行匹配。主要终点是HR阳性乳腺癌患者的无病生存期(DFS)和总生存期(OS),次要终点是HR阴性乳腺癌患者及全体人群的DFS和OS。亚组分析包括术后5年内怀孕患者的DFS以及怀孕组中根据ET间隔时间(≤30个月对>30个月)的DFS。
我们的研究共纳入1323例YBC患者,其中包括68例怀孕患者和264例匹配的未怀孕患者。HR阳性患者(分别为P = 0.657,P = 0.250)和全体人群(分别为P = 0.058,P = 0.152)的DFS和OS无统计学显著差异。乳腺癌妊娠间隔≤5年显示出更好的DFS(P = 0.042),ET间隔≤30个月的DFS较差(P = 0.01)。
本研究未观察到乳腺癌手术后怀孕的HR阳性疾病患者预后更差,且怀孕患者ET间隔小于30个月会导致更差的结局。患者术后5年内能够怀孕。