Pregnancy-associated breast cancer: a case-control study in a young population with a high-fertility rate
Pregnancy-associated breast cancer: a case-control study in a young population with a high-fertility rate
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DOI：
10.1007/bf02782194
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发表时间：
2000-11-01
期刊：
影响因子：
3.4
通讯作者：
Mohammed, GH
中科院分区：
文献类型：
--
作者：
Ibrahim, EM;Ezzat, AA;Mohammed, GH
妊娠相关乳腺癌（PABC）并不是罕见事件。该协会经常提出管理挑战。我们打算回顾五年内在同一机构就诊的 PABC 患者的临床特征、治疗和结果，并将其与匹配的对照组进行比较。对妊娠期间诊断的所有 PABC 患者的数据进行回顾性审查（第一组）。对于第一组中的每名患者，确定了三名未怀孕的乳腺癌匹配对照（第二组的年龄、分期和诊断年份进行匹配）。确定了第一组中的 72 名患者和第二组中的 216 名患者。他们的中位年龄相似（分别为 34 岁和 35 岁）。第一组和第二组患者先前怀孕的中位数为 5 次。与对照组相比，患者在诊断前的症状持续时间较短（5.6 个月与 9.4 个月，P < 0.0001）。分别有 3%、31%、40% 和 26% 的患者处于 I 至 IV 期。这种模式与我们在乳腺癌人群中看到的模式相似。 34 名患者 (47%) 终止妊娠，38 名患者 (53%) 自然阴道分娩正常。 I组47例接受手术； 37 名（52%）接受改良根治性乳房切除术，10 名（14%）接受保守手术。 37 名患者在终止妊娠后进行了手术，10 名患者在怀孕期间进行了手术。第一组患者的阳性淋巴结中位数为 4 个，而第二组患者的阳性淋巴结中位数为 2 个。 I 组中没有患者在妊娠早期接受全身化疗，而在妊娠中期和晚期分别只有 4 例 (6%) 和 3 例 (4%) 患者接受辅助或新辅助治疗。未诊断出新生儿有先天性畸形。第一组患者在怀孕期间没有接受放射治疗。在中位 47.5 个月的时间里，第一组有 48 名患者 (67%) 存活，而第二组有 126 名患者 (58%) 存活，中位生存期没有差异 (P = 0.79)。比较两组之间的总生存期（OS）也没有显示出显着差异。两组之间的无进展生存期也没有差异。 Cox 比例风险模型将晚期阶段确定为影响 I 组 OS 的唯一独立不良预后变量。尽管该系列包括生育率较高的相对年轻人群，但该研究证实 PABC 患者与其匹配对照之间缺乏生存差异。
Pregnancy-associated breast cancer (PABC) is not a rare event. The association frequently imposes a management challenge. We intended to review the clinical features, therapy, and outcome of patients with PABC seen at a single institution over a five-year period and to compare those with that seen in a matched control group.Data of all patients with PABC diagnosed during pregnancy were retrospectively reviewed (Group I). For each patient in Group I, three matched controls with breast cancer without pregnancy were identified (matched for age, stage, and year of diagnosis, Group II).72 patients in Group I and 216 in Group II were identified. Their median age was similar (34 vs 35 y, respectively). The median number of prior pregnancies for patients in Groups I and II was 5. Patients had shorter duration of symptoms prior to diagnosis as compared with their controls (5.6 vs 9.4 months, P < 0.0001). 3%, 31%, 40%, and 26% of patients had Stage I to IV, respectively. A pattern that was similar to that seen in our breast cancer population. Pregnancy was terminated in 34 patients (47%), while 38 (53%) had normal spontaneous vaginal delivery. 47 patients in Group I had surgery; 37 (52%) had modified radical mastectomy and 10 (14%) had conservative surgery. In 37 patients surgery was performed after termination of pregnancy and 10 had surgery performed during pregnancy. The median number of positive lymph nodes in Group I was 4 as compared with 2 for patients in Group II. No patients in Group I had systemic chemotherapy during first trimester, while only 4 (6%) and 3 (4%) received adjuvant or neoadjuvant during second and third trimester, respectively. No congenital malformation in the newborns was diagnosed. None of the patients in Group I received radiotherapy during pregnancy. Over a median of 47.5 months, 48 (67%) patients in Group I were alive as compared to 126 (58%) in Group II, with no difference in the median survival (P = 0.79). Comparing overall survival (OS) between the two groups stage for stage also showed no significant difference. Also there was no difference in progression-free survival between the two groups. Cox proportional hazard model identified advanced stage as the only independent adverse prognostic variable that influenced OS in Group I. Despite that this series included a relatively young population with a high fertility rate, the study confirmed the lack of a survival difference between patients with PABC and their matched controls.