Breast cancer diagnosed during pregnancy and lactation: biological features and treatment options
Breast cancer diagnosed during pregnancy and lactation: biological features and treatment options
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DOI：
10.1016/j.ejso.2004.11.012
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发表时间：
2005-04-01
期刊：
影响因子：
3.8
通讯作者：
Veronesi, U
中科院分区：
文献类型：
--
作者：
Gentilini, O;Masullo, M;Veronesi, U
研究的目的。妊娠或哺乳期乳腺癌患者的生物学特征及治疗评估。患者和方法。本文对21例妊娠期乳腺癌（BCdP）和17例哺乳期乳腺癌（BCdL）患者的雌激素受体（ER）和孕激素受体（PgR）、Ki-67、HER2/neu、预后指标、治疗及随访情况进行了免疫组化分析。中位年龄分别为36岁和33岁，中位肿瘤大小分别为2.4和2.5 cm， 21例孕妇中有10例腋窝淋巴结阳性，17例哺乳期患者中有11例腋窝淋巴结阳性。21名孕妇中的6名和17名哺乳期患者中的9名均未表达ER和PgR。所有6名同时诊断为乳腺癌和妊娠（妊娠早期）的妇女都倾向于终止妊娠，尽管讨论了另一种选择。5例患者在妊娠中期和晚期接受含四环素的化疗，患者和儿童均无并发症。21例妊娠期患者中有15例进行了保守手术，中位随访24个月后无局部复发。3例孕妇接受了淋巴显像检查和前哨淋巴结活检。同时诊断为乳腺癌和妊娠（妊娠早期）的患者更倾向于终止妊娠，以便更容易完成治疗。保守手术对BCdP患者也是安全的。腋窝临床阴性的孕妇可考虑前哨淋巴结活检。(c) 2004 Elsevier Ltd.版权所有。
Aim of the study. Assessment of biological features and treatment of patients with breast cancer presenting during pregnancy or lactation.Patients and methods. Immunohistochemical analysis of estrogen receptor (ER) and progesteron receptor (PgR), Ki-67, HER2/neu, prognostic markers, treatment and follow-up of 21 patients with breast cancer during pregnancy (BCdP) and 17 with breast cancer during lactation (BCdL) are presented.Results. Median age was 36 and 33 years, median tumour size was 2.4 and 2.5 cm, axillary lymph nodes were positive in 10 of 21 pregnant patients and 11 of 17 lactating patients, respectively. Both ER and PgR were not expressed in six of 21 pregnant women and nine of 17 lactating patients. All the six women who had concurrent diagnosis of breast cancer and pregnancy (first trimester) preferred termination of pregnancy although an alternative option was discussed. Five patients received antracyclin containing chemotherapy during the second and third trimester with no complications for patient and child. Conservative surgery was performed in 15 of 21 patients during pregnancy with no local reappearance after a median follow-up of 24 months. Three pregnant women underwent lymphoscintigraphy and sentinel lymph node biopsy.Conclusions. Patients who had concurrent diagnosis of breast cancer and pregnancy (early first trimester) preferred termination of pregnancy to allow easier completion of treatment. Conservative surgery was safe also in women with BCdP. Sentinel node biopsy might be considered for pregnant patients with a clinically negative axilla. (c) 2004 Elsevier Ltd. All rights reserved.