Department of Obstetrics and Gynaecology, Niigata City General Hospital, 463-7, Shumoku, Chuo-ku, Niigata, 950-1197, Japan.
Department of Breast Surgery, Niigata City General Hospital, 463-7, Shumoku, Chuo-ku, Niigata, 950-1197, Japan.
BMC Womens Health. 2021 Apr 15;21(1):153. doi: 10.1186/s12905-021-01298-1.
Low back pain during pregnancy and postpartum is common and might not arouse clinical interest. Pregnancy-associated breast cancer is often found as a breast mass, but its diagnosis is difficult during pregnancy and postpartum. As more women delay their first pregnancies, its incidence may increase in the future.
The patient was a 30-year-old gravida 3, para 3. She had low back pain from the second trimester of her previous two pregnancies, which improved spontaneously after delivery. In her third pregnancy, she again developed low back pain in the second trimester. Her delivery was normal. However, her low back pain continued for up to 7 months postpartum and then worsened sharply. A whole-body scan revealed a compression fracture due to multiple spinal metastases of breast cancer. As she had not complained about her breasts, they had not been closely examined.
This case shows the importance of considering bone metastases from breast cancer in the differential diagnosis of patients with low back pain during pregnancy and postpartum.
孕期和产后腰痛很常见,可能不会引起临床关注。妊娠相关性乳腺癌常表现为乳房肿块,但在孕期和产后诊断较为困难。随着越来越多的女性推迟首次妊娠,其发病率未来可能会上升。
患者为 30 岁,孕 3 产 3。她在之前两次妊娠的中期出现腰痛,分娩后可自行缓解。第三次妊娠时,她再次在中期出现腰痛。分娩正常。但产后 7 个月腰痛持续不缓解,且逐渐加重。全身扫描显示多发脊柱转移导致多处压缩性骨折。由于她未主诉乳房不适,故未仔细检查。
该病例提示在孕期和产后腰痛的鉴别诊断中应考虑乳腺癌骨转移。