Division of Breast and Thyroid Surgical Oncology, Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2022 Oct 7;101(40):e30831. doi: 10.1097/MD.0000000000030831.
In recent years, postponing childbearing has increased the prevalence of pregnancy-associated breast cancer (PABC). PABC has a poorer prognosis than breast cancer not associated with pregnancy (non-PABC) due to delayed diagnosis and aggressive subtype. Additionally, pregnancy itself predicts a poor prognosis; but, this is a subject of debate. Thus, we analyzed the effects of known prognostic factors and pregnancy on the prognosis of PABC. We retrospectively analyzed women aged 20 to 49 years who were diagnosed with breast cancer (BC) between 1989 and 2014. Patients were distributed into PABC and non-PABC groups, and 1:4 propensity score matching was performed to adjust for baseline characteristics. Primary endpoints were overall survival (OS) and BC-specific survival (BCSS). Secondary endpoint was the difference in prognosis according to BC subtype. Of the 34,970 recruited patients with BC, 410 (1.2%) had PABC. Patients with PABC were younger and tended to have triple-negative BC (TNBC) subtype than non-PABC patients. The 1640 matched non-PABC patients showed a significantly worse mean survival rate than the unmatched non-PABC patients. Patients with PABC had a significantly worse OS and BCSS than those with non-PABC. In multivariate analyses, patients with PABC of luminal B (Ki-67 ≥14.0%) and TNBC subtypes had worse OS and BCSS than patients with non-PABC. Patients with PABC had poorer prognosis than non-PABC patients after adjusting for several prognostic factors. This difference was particularly significant in patients with the luminal B and TNBC subtypes.
近年来，推迟生育导致妊娠相关性乳腺癌（PABC）的发病率增加。由于诊断延迟和侵袭性亚型，PABC 的预后较非妊娠相关性乳腺癌（non-PABC）差。此外，妊娠本身预测预后不良，但这是一个有争议的问题。因此，我们分析了已知的预后因素和妊娠对 PABC 预后的影响。我们回顾性分析了 1989 年至 2014 年间诊断为乳腺癌（BC）的 20 至 49 岁女性患者。患者分为 PABC 和 non-PABC 组，并进行了 1:4 的倾向评分匹配以调整基线特征。主要终点是总生存期（OS）和 BC 特异性生存期（BCSS）。次要终点是根据 BC 亚型预后的差异。在招募的 34970 例 BC 患者中，有 410 例（1.2%）为 PABC。与 non-PABC 患者相比，PABC 患者年龄较小，且倾向于具有三阴性乳腺癌（TNBC）亚型。1640 名匹配的 non-PABC 患者的平均生存率明显低于未匹配的 non-PABC 患者。与 non-PABC 患者相比，PABC 患者的 OS 和 BCSS 明显更差。在多变量分析中，Ki-67≥14.0%的 luminal B 和 TNBC 亚型的 PABC 患者的 OS 和 BCSS 较 non-PABC 患者差。调整了几个预后因素后，PABC 患者的预后比 non-PABC 患者差。在 luminal B 和 TNBC 亚型患者中，这种差异尤其显著。
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