Unit of Virus Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Clin Breast Cancer. 2022 Jun;22(4):e517-e525. doi: 10.1016/j.clbc.2021.11.009. Epub 2021 Dec 1.
Pregnancy rarely coincides with breast cancer, but when it does, uncertainties remain about how survival is affected. In a nation-wide study, we investigated survival in women diagnosed with breast cancer during pregnancy.
Through health registries, we identified women with breast cancer at ages 15-44 years from 1973-2016 in Denmark and included 156 who were pregnant at diagnosis and 11,110 who were not. We compared overall mortality in pregnant and non-pregnant women using multivariate Cox regression stratified by time since cancer: <2 and ≥2 years.
During the first 2 years after diagnosis, the hazard ratio of overall death was 2.28 (95% CI: 1.48-3.52) for pregnant versus non-pregnant breast cancer patients after adjustment for age and calendar period and 1.62 (95% CI: 1.05-2.50) after further adjustment for extent of disease. Adjusting for additional tumor characteristics, the hazard ratio was still significantly increased. Beyond the first 2 years, there was no excess mortality.
Our study identifies the early period after breast cancer as a period of particular interest in future studies on survival after breast cancer in pregnancy. We found no evidence that survival is affected by pregnancy when 2 or more years have passed since diagnosis.
怀孕很少与乳腺癌同时发生,但当这种情况发生时,关于生存受到何种影响仍存在不确定性。在一项全国性研究中,我们调查了怀孕期间被诊断患有乳腺癌的女性的生存情况。
通过健康登记册,我们从 1973 年至 2016 年在丹麦确定了年龄在 15-44 岁之间患有乳腺癌的女性,其中包括 156 名在诊断时怀孕的女性和 11,110 名未怀孕的女性。我们通过多变量 Cox 回归,根据癌症发生后的时间(<2 年和≥2 年)对怀孕和非怀孕的乳腺癌患者的总死亡率进行了比较。
在诊断后的前 2 年内,调整年龄和日历时间后,与非怀孕的乳腺癌患者相比,怀孕的乳腺癌患者的总体死亡风险比为 2.28(95%CI:1.48-3.52),进一步调整疾病程度后为 1.62(95%CI:1.05-2.50)。在调整更多肿瘤特征后,风险比仍然显著增加。超过前 2 年,死亡率没有增加。
我们的研究确定了乳腺癌诊断后早期是未来研究怀孕相关乳腺癌生存的一个特别关注的时期。我们没有发现证据表明,当诊断后已经过去 2 年或更长时间时,怀孕会影响生存。