Survival Outcomes in Pregnancy Associated Breast Cancer: A Retrospective Case Control Study
Survival Outcomes in Pregnancy Associated Breast Cancer: A Retrospective Case Control Study
复制标题
DOI：
10.1111/j.1524-4741.2011.01201.x
复制
发表时间：
2012-03-01
期刊：
影响因子：
2.1
通讯作者：
Vogel, Victor
中科院分区：
文献类型：
--
作者：
Ali, Sheikh Asim;Gupta, Sameer;Vogel, Victor
妊娠相关性乳腺癌（PABC）被定义为在妊娠期间或分娩后一年内诊断出的乳腺癌。据信，在调整年龄和分期后，怀孕和非怀孕妇女的5年生存率是相同的。我们对1990年至2005年间在我们机构接受治疗的患者进行了一项回顾性病例对照研究，以比较PABC与未怀孕的乳腺癌患者的5年生存结局。采用KaplanMeier法估计总生存期（OS）和无病生存期（DFS），并采用对数秩检验评估OS、DFS与妊娠状态、HER-2状态、ER/PR状态和家族史之间的关系。两组的中位年龄为33岁（范围24 - 42岁）。22例（55%）PABC患者ER/PR受体阳性，而对照组为20例（50%）。90%的PABC患者接受了化疗，而非妊娠组为87.5%。91.5%的PABC患者接受了保乳手术，8.5%的患者接受了乳房切除术，而对照组分别为86%和14%。PABC组的中位OS为4.9年，而对照组为6年（p = 0.02）。PABC组的中位DFS为2.7年，而对照组为5.1年（p = 0.01）。PABC组最常见的复发部位是骨（27%），对照组为局部复发（33%）。单因素分析显示，OS和DFS与妊娠状态、家族史、ER/PR状态和分期相关。调整年龄和分期后，PABC患者与未妊娠对照组相比，死亡（p = 0.01）和复发（p = 0.02）的风险更高。PABC患者的OS和DFS显著短于非妊娠年龄和分期匹配的对照组。
Pregnancy-associated breast cancer (PABC) has been defined as breast cancer diagnosed during pregnancy or within one year of delivery. It is believed that after adjusting for age and stage, the 5-year survival rates are the same in both pregnant and nonpregnant women. We conducted a retrospective case-control study among patients treated at our institution between 1990 and 2005 to compare the 5-year survival outcomes for PABC with women treated for breast cancer who were not pregnant. Overall survival (OS) and disease-free survival (DFS) were estimated by the KaplanMeier method, and log rank tests were used to assess the associations between OS, DFS and pregnancy status, HER-2 status, ER/PR status, and family history. The median age was 33 years (range 2442) for both groups. Twenty-two (55%) patients with PABC were ER/PR receptor positive compared with 20 (50%) for the controls. Ninety percent of patients with PABC received chemotherapy compared with 87.5% in the nonpregnant group. 91.5% of patients with PABC had breast-conserving surgery and 8.5% had mastectomies compared with 86% and 14%, respectively, for the control group. The median OS was 4.9 years in the PABC group compared with 6 years for the controls (p = 0.02). The median DFS was 2.7 years for the PABC group compared with 5.1 years for the controls (p = 0.01). The most common site of relapse was bone for the PABC group (27%) and local recurrence (33%) for the controls. Univariate analysis revealed that OS and DFS were associated with pregnancy status, family history, ER/PR status, and stage. After adjusting for age and stage, PABC patients had higher risk of both death (p = 0.01) and recurrence (p = 0.02) compared with nonpregnant controls. Women with PABC had significantly shorter OS and DFS compared with nonpregnant age and stage-matched controls.