Department of Oncology, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Flanders, Belgium.
Department of Gynecology, AVL NKI, Amsterdam, Noord-Holland, The Netherlands.
Int J Gynecol Cancer. 2021 Mar;31(3):412-422. doi: 10.1136/ijgc-2020-002072.
Breast cancers that occur in young women up to 5 to 10 years' postpartum are associated with an increased risk for metastasis and death compared with breast cancers diagnosed in young, premenopausal women during or outside pregnancy. Given the trend to delay childbearing, this frequency is expected to increase. The (immuno)biology of postpartum breast cancer is poorly understood and, hence, it is unknown why postpartum breast cancer has an enhanced risk for metastasis or how it should be effectively targeted for improved survival. The poorer prognosis of women diagnosed within 10 years of a completed pregnancy is most often contributed to the effects of mammary gland involution. We will discuss the most recent data and mechanistic insights of the most important processes associated with involution and their role in the adverse effects of a postpartum diagnosis. We will also look into the effect of lactation on breast cancer outcome after diagnosis. In addition, we will discuss the available treatment strategies that are currently being used to treat postpartum breast cancer, keeping in mind the importance of fertility preservation in this group of young women. These additional insights might offer potential therapeutic options for the improved treatment of women with this specific condition.
产后 5 至 10 年内发生的年轻女性乳腺癌与转移和死亡风险增加相关，与怀孕期间或怀孕后诊断的年轻绝经前女性的乳腺癌相比。鉴于生育延迟的趋势，这种频率预计会增加。产后乳腺癌的（免疫）生物学尚未完全了解，因此，尚不清楚为什么产后乳腺癌转移风险增加，以及如何针对其进行有效靶向以提高生存率。在完成妊娠后 10 年内被诊断的女性预后较差，这主要归因于乳腺退化的影响。我们将讨论与退化相关的最重要过程的最新数据和机制见解，以及它们在产后诊断的不良影响中的作用。我们还将研究哺乳对诊断后乳腺癌结局的影响。此外，我们将讨论目前用于治疗产后乳腺癌的可用治疗策略，同时牢记这一年轻女性群体的生育保存的重要性。这些额外的见解可能为改善特定情况下女性的治疗提供潜在的治疗选择。
