中国多中心妊娠相关性乳腺癌患者的回顾性临床研究（CSBrS-008）。
A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008).
机构信息
Department of Breast Surgery, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.
Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai 200011, China.
出版信息
Chin Med J (Engl). 2021 Sep 15;134(18):2186-2195. doi: 10.1097/CM9.0000000000001697.
BACKGROUND
Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China.
METHODS
According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method.
RESULTS
A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24-47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3-59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died.
CONCLUSIONS
It is safe and feasible to standardize surgery and chemotherapy for PABC.
背景
妊娠相关性乳腺癌（PABC）是一种特殊类型的乳腺癌，发生于妊娠期间及产后 1 年内。随着社会快速发展和中国生育政策调整，女性初产年龄逐渐增大，预计 PABC 的发病率将升高。本研究旨在基于中国多中心大样本，积累临床经验，调查并总结 PABC 的发病情况、诊断和治疗。
方法
依据中国抗癌协会乳腺癌专业委员会，纳入 2016 年 1 月至 2018 年 12 月 27 家医院的 164 例 PABC 患者，回顾性分析其妊娠状态、临床病理特征、综合治疗方法及转归，采用 Kaplan-Meier 法绘制生存曲线。
结果
共纳入 164 例 PABC 患者，占同期病例总数的 0.30%；其中妊娠中诊断 83 例，哺乳期诊断 81 例。PABC 患者中位年龄 33 岁（24～47 岁），Ⅰ期占 9.1%（15/164），Ⅱ期 54.9%（90/164），Ⅲ期 24.4%（40/164），Ⅳ期 2.4%（4/164）；9.1%（15/164）患者为 Luminal A 型，Luminal B 型最多见（43.3%[71/164]），人表皮生长因子受体 2（Her-2）过表达 15.2%（25/164），三阴性乳腺癌 18.9%（31/164）；妊娠乳腺癌中，36.1%（30/83）直接手术，20.5%（17/83）妊娠期间化疗，20.5%（17/83）行流产/引产；中位随访时间 36 个月（3～59 个月），11.0%（18/164）患者出现局部复发或远处转移，3.0%（5/164）死亡。
结论
PABC 规范化手术和化疗安全可行。
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