Kang Minsun, Chun Yong Soon, Park Heung Kyu, Cho Eun Kyung, Jung Jaehun, Kim Yunyeong
Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of General Surgery, Breast Cancer Center, Gachon University Gil Medical Center, Incheon, Korea.
Ann Surg Treat Res. 2022 Feb;102(2):73-82. doi: 10.4174/astr.2022.102.2.73. Epub 2022 Feb 4.
Long-term safety of pregnancy after breast cancer (BC) remains controversial, especially with respect to BC biological subtypes.
We analyzed a population-based retrospective cohort with BC from 2002 to 2017. Patient-level 1:1 matching was performed between pregnant and nonpregnant women. The study population was categorized into 6 biological subtypes based on the combination of prescribed therapies. Subanalyses were performed considering the time to pregnancy after BC diagnosis, systemic therapy, and pregnancy outcomes.
We identified 544 matched women with BC, who were assigned to the pregnant (cases, n = 272) or nonpregnant group (controls, n = 272) of similar characteristics, adjusted for guaranteed bias. These patients were followed up for 10 years, or disease and mortality occurrence after the diagnosis of BC. Survival estimates were calculated. The actuarial 10-year overall survival (OS) rates were 97.4% and 91.9% for pregnant and nonpregnant patients, respectively. The pregnant group showed significantly better OS (adjusted hazard ratio [aHR], 0.29; 95% confidence interval [CI], 0.12-0.68; P = 0.005) and did not have a significantly inferior disease-free survival (aHR, 1.10; 95% CI, 0.61-1.99; P = 0.760).
Consistent outcomes were observed in every subgroup analysis. Our observational data provides reassuring evidence on the long-term safety of pregnancy in young patients with BC regardless of the BC biological subtype.
乳腺癌（BC）后妊娠的长期安全性仍存在争议，尤其是在BC生物学亚型方面。
我们分析了2002年至2017年基于人群的BC回顾性队列。对孕妇和非孕妇进行患者水平的1:1匹配。根据规定治疗的组合将研究人群分为6种生物学亚型。考虑到BC诊断后至妊娠的时间、全身治疗和妊娠结局进行亚组分析。
我们确定了544名匹配的BC女性，她们被分配到具有相似特征的妊娠组（病例，n = 272）或非妊娠组（对照，n = 272），并对保证偏差进行了调整。这些患者随访10年，或随访至BC诊断后的疾病和死亡发生情况。计算生存估计值。妊娠和非妊娠患者的精算10年总生存率（OS）分别为97.4%和91.9%。妊娠组的OS显著更好（调整后风险比[aHR]，0.29；95%置信区间[CI]，0.12 - 0.68；P = 0.005），且无病生存率无显著降低（aHR，1.10；95% CI，0.61 - 1.99；P = 0.760）。
在每项亚组分析中均观察到一致的结果。我们的观察数据为年轻BC患者妊娠的长期安全性提供了令人安心的证据，无论BC生物学亚型如何。
