Zhang Mingdi, Zhou Jing, Wang Ling
Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Biosci Trends. 2021 Nov 21;15(5):276-282. doi: 10.5582/bst.2021.01187. Epub 2021 Sep 23.
Breast cancer diagnosed during pregnancy poses ethical and professional challenges. Clinical management of that condition should ensure the safety of both the mother and fetus. Clinical trials on breast cancer exclude pregnant women, so sufficient evidence with which to formulate guidelines for the management of these patients is lacking. Failing to undergo a breast examination during pregnancy, breast symptoms explained by physiological changes such as pregnancy, and unnecessary abortions after the diagnosis of breast cancer lead to worse outcomes for these patients. Multidisciplinary teams including breast surgeons, obstetricians, radiologists, pathologists, and anesthesiologists need to make an early diagnosis and comprehensively evaluate patients in different gestational weeks and with different stages of breast cancer in order to optimize outcomes.
孕期诊断出的乳腺癌带来了伦理和专业方面的挑战。该病症的临床管理应确保母亲和胎儿的安全。乳腺癌临床试验将孕妇排除在外，因此缺乏制定这些患者管理指南的充分证据。孕期未进行乳房检查、将乳房症状归因于怀孕等生理变化以及乳腺癌诊断后不必要的流产都会导致这些患者的预后更差。包括乳腺外科医生、产科医生、放射科医生、病理科医生和麻醉科医生在内的多学科团队需要进行早期诊断，并对处于不同孕周和不同乳腺癌分期的患者进行全面评估，以优化治疗结果。
