DiFronzo L A, O'Connell T X
Department of Surgery, Kaiser Permanente Medical Center, Los Angeles, California, USA.
Surg Clin North Am. 1996 Apr;76(2):267-78. doi: 10.1016/s0039-6109(05)70438-2.
Although breast cancer is the most common malignancy in pregnancy, its overall incidence remains low. It appears that pregnancy and breast cancer are merely coincidental and that pregnancy does not directly contribute to the development or accelerated progression of breast cancer. The majority of studies have documented a significant delay in diagnosis secondary to physiologic changes of the breast during pregnancy and have reasoned that this is the likely explanation for the advanced stage of disease upon initial presentation. Although pregnant patients present at a later stage of breast cancer, survival stage for stage is the same when pregnant patients are compared with young nonpregnant patients with breast cancer. A suspicious breast mass in a pregnant patient should be biopsied and appropriately treated, without need for extensive preoperative staging. Therapeutic abortion should be performed only on an individual basis, namely in patients in whom necessary radiation or chemotherapy would be detrimental to the developing fetus and in whom a significant delay of this treatment would be harmful. In patients with early-stage disease, it is recommended to wait 2 years after treatment of breast cancer for subsequent pregnancy; however, in women with advanced disease, subsequent pregnancy should be discouraged.
尽管乳腺癌是妊娠期最常见的恶性肿瘤，但其总体发病率仍然较低。妊娠和乳腺癌似乎只是巧合，妊娠并不会直接导致乳腺癌的发生或加速其进展。大多数研究记录了由于孕期乳房生理变化导致诊断显著延迟，并推断这可能是初次就诊时疾病处于晚期的原因。尽管妊娠患者乳腺癌就诊时处于较晚阶段，但与年轻非妊娠乳腺癌患者相比，妊娠患者的分期生存率相同。妊娠患者的可疑乳房肿块应进行活检并适当治疗，无需进行广泛的术前分期。治疗性流产仅应根据个体情况进行，即在必要的放疗或化疗会对发育中的胎儿有害且该治疗的显著延迟会有害的患者中进行。对于早期疾病患者，建议在乳腺癌治疗后等待2年再怀孕；然而，对于晚期疾病的女性，应不鼓励其随后怀孕。
