目的 探討妊娠期乳腺癌的診斷、治療及預(yù)后。
方法 回顧性分析1986年1月至2007年12月期間筆者所在醫(yī)院收治的12例妊娠期乳腺癌患者的臨床資料和隨訪資料。
結(jié)果 12例妊娠期乳腺癌患者中,有8例患者于術(shù)前行B超檢查,3例患者行鉬靶檢查,均有陽性發(fā)現(xiàn)。12例患者均行手術(shù)治療,其中10例行乳腺癌改良根治術(shù),2例行乳腺癌根治術(shù);7例在妊娠期間確診的患者中,僅1例行人流術(shù),另外6例行剖宮產(chǎn);所有患者乳腺癌術(shù)后并妊娠結(jié)束后均行化療,5例化療后再行放療,1例在妊娠結(jié)束后行內(nèi)分泌治療。隨訪期間(平均隨訪時間35.8個月),1例患者出現(xiàn)胸壁結(jié)節(jié),2例盆腔多發(fā)轉(zhuǎn)移并死亡,余9例均未出現(xiàn)復(fù)發(fā)和轉(zhuǎn)移。
結(jié)論 妊娠期乳腺癌可行乳腺切除加腋窩淋巴結(jié)清掃術(shù); 妊娠結(jié)束后可行化療,妊娠期間不應(yīng)行放療及內(nèi)分泌治療。
引用本文: 鐘穎,孫強,黃漢源,周易冬,茅楓,關(guān)競紅,林燕,徐雅莉. 妊娠期乳腺癌的診斷和治療△. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(12): 1332-1334. doi: 復(fù)制
1. | Pommier RF, Fields SA. Breast cancer in pregnancy——a diagnostic and therapeutic challenge[J]. West J Med, 1995, 163(1):70-71. |
2. | Wallack MK, James AJ, Bedwinek J, et al. Gestational carcinoma of the female breast[J]. Curr Probl Cancer, 1983, 7(9):1-58. |
3. | Berry DL, Theriault RL, Holmes FA, et al. Management of breast cancer during pregnancy using a standardized protocol[J]. J Clin Oncol, 1999, 17(3):855-861. |
4. | Middleton LP, Amin M, Gwyn K, et al. Breast carcinoma in pregnant women:assessment of clinicopathologic and immunohistochemical features[J]. Cancer, 2003, 98(5):1055-1060. |
5. | Nicklas AH, Baker ME. Imaging strategies in the pregnant cancerpatient[J]. Semin Oncol, 2000, 27(6):623-632. |
6. | Ahn BY, Kim HH, Moon WK, et al. Pregnancy- and lactation-associated breast cancer:mammographic and sonographic findings[J]. J Ultrasound Med, 2003, 22(5):491-497. |
7. | Osei EK, Faulkner K. Fetal doses from radiological examinations[J]. Br J Radiol, 1999, 72(860):773-780. |
8. | Petrek JA. Breast cancer during pregnancy[J]. Cancer, 1994, 74(1 Suppl):518-527. |
9. | Shousha S. Breast carcinoma presenting during or shortly after pregnancy and lactation[J]. Arch Pathol Lab Med, 2000, 124(7):1053-1060. |
10. | Helewa M, Lévesque P, Provencher D, et al. Breast cancer, pregnancy, and breastfeeding[J]. J Obstet Gynaecol Can, 2002, 24(2):164-180. |
11. | Ring AE, Smith IE, Jones A, et al. Chemotherapy for breast cancer during pregnancy:an 18-year experience from five London teaching hospitals[J]. J Clin Oncol, 2005, 23(18):4192-4197. |
12. | Gwyn K. Children exposed to chemotherapy in utero[J]. J Natl Cancer Inst Monogr, 2005,34:69-71. |
13. | Cuvier C, Espie M, Extra JM, et al. Vinorelbine in pregnancy[J]. Eur J Cancer, 1997, 33(1):168-169. |
14. | Sood AK, Shahin MS, Sorosky JI. Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy[J].Gynecol Oncol, 2001, 83(3):599-600. |
15. | Gadducci A, Cosio S, Fanucchi A, et al. Chemotherapy with epirubicin and paclitaxel for breast cancer during pregnancy:case report and review of the literature[J]. Anticancer Res, 2003, 23(6D):5225-5229. |
16. | De Santis M, Lucchese A, De Carolis S, et al. Metastatic breast cancer in pregnancy:first case of chemotherapy with docetaxel[J]. Eur J Cancer Care (Engl), 2000, 9(4):235-237. |
17. | Bradley B, Fleck A, Osei EK. Normalized data for the estimation of fetal radiation dose from radiotherapy of the breast[J]. Br J Radiol, 2006, 79(946):818-827. |
18. | Greskovich JF Jr, Macklis RM. Radiation therapy in pregnancy:risk calculation and risk minimization[J]. Semin Oncol, 2000, 27(6):633-645. |
19. | Mayr NA, Wen BC, Saw CB. Radiation therapy during pregnancy[J]. Obstet Gynecol Clin North Am, 1998, 25(2):301-321. |
20. | Mazze RI, Källén B. Reproductive outcome after anesthesia and operation during pregnancy:a registry study of 5 405 cases[J]. Am J Obstet Gynecol, 1989, 161(5):1178-1185. |
21. | Bader AA, Schlembach D, Tamussino KF, et al. Anhydramnios associated with administration of trastuzumab and paclitaxel for metastatic breast cancer during pregnancy[J]. Lancet Oncol, 2007, 8(1):79-81. |
22. | White TT. Carcinoma of the breast and pregnancy;analysis of 920 cases collected from the literature and 22 new cases[J]. Ann Surg, 1954, 139(1):9-18. |
23. | Dunlop DJ, Soukop M, McEwan HP. Antenatal administration of aminopropylidene diphosphonate[J]. Ann Rheum Dis, 1990, 49(11):955. |
- 1. Pommier RF, Fields SA. Breast cancer in pregnancy——a diagnostic and therapeutic challenge[J]. West J Med, 1995, 163(1):70-71.
- 2. Wallack MK, James AJ, Bedwinek J, et al. Gestational carcinoma of the female breast[J]. Curr Probl Cancer, 1983, 7(9):1-58.
- 3. Berry DL, Theriault RL, Holmes FA, et al. Management of breast cancer during pregnancy using a standardized protocol[J]. J Clin Oncol, 1999, 17(3):855-861.
- 4. Middleton LP, Amin M, Gwyn K, et al. Breast carcinoma in pregnant women:assessment of clinicopathologic and immunohistochemical features[J]. Cancer, 2003, 98(5):1055-1060.
- 5. Nicklas AH, Baker ME. Imaging strategies in the pregnant cancerpatient[J]. Semin Oncol, 2000, 27(6):623-632.
- 6. Ahn BY, Kim HH, Moon WK, et al. Pregnancy- and lactation-associated breast cancer:mammographic and sonographic findings[J]. J Ultrasound Med, 2003, 22(5):491-497.
- 7. Osei EK, Faulkner K. Fetal doses from radiological examinations[J]. Br J Radiol, 1999, 72(860):773-780.
- 8. Petrek JA. Breast cancer during pregnancy[J]. Cancer, 1994, 74(1 Suppl):518-527.
- 9. Shousha S. Breast carcinoma presenting during or shortly after pregnancy and lactation[J]. Arch Pathol Lab Med, 2000, 124(7):1053-1060.
- 10. Helewa M, Lévesque P, Provencher D, et al. Breast cancer, pregnancy, and breastfeeding[J]. J Obstet Gynaecol Can, 2002, 24(2):164-180.
- 11. Ring AE, Smith IE, Jones A, et al. Chemotherapy for breast cancer during pregnancy:an 18-year experience from five London teaching hospitals[J]. J Clin Oncol, 2005, 23(18):4192-4197.
- 12. Gwyn K. Children exposed to chemotherapy in utero[J]. J Natl Cancer Inst Monogr, 2005,34:69-71.
- 13. Cuvier C, Espie M, Extra JM, et al. Vinorelbine in pregnancy[J]. Eur J Cancer, 1997, 33(1):168-169.
- 14. Sood AK, Shahin MS, Sorosky JI. Paclitaxel and platinum chemotherapy for ovarian carcinoma during pregnancy[J].Gynecol Oncol, 2001, 83(3):599-600.
- 15. Gadducci A, Cosio S, Fanucchi A, et al. Chemotherapy with epirubicin and paclitaxel for breast cancer during pregnancy:case report and review of the literature[J]. Anticancer Res, 2003, 23(6D):5225-5229.
- 16. De Santis M, Lucchese A, De Carolis S, et al. Metastatic breast cancer in pregnancy:first case of chemotherapy with docetaxel[J]. Eur J Cancer Care (Engl), 2000, 9(4):235-237.
- 17. Bradley B, Fleck A, Osei EK. Normalized data for the estimation of fetal radiation dose from radiotherapy of the breast[J]. Br J Radiol, 2006, 79(946):818-827.
- 18. Greskovich JF Jr, Macklis RM. Radiation therapy in pregnancy:risk calculation and risk minimization[J]. Semin Oncol, 2000, 27(6):633-645.
- 19. Mayr NA, Wen BC, Saw CB. Radiation therapy during pregnancy[J]. Obstet Gynecol Clin North Am, 1998, 25(2):301-321.
- 20. Mazze RI, Källén B. Reproductive outcome after anesthesia and operation during pregnancy:a registry study of 5 405 cases[J]. Am J Obstet Gynecol, 1989, 161(5):1178-1185.
- 21. Bader AA, Schlembach D, Tamussino KF, et al. Anhydramnios associated with administration of trastuzumab and paclitaxel for metastatic breast cancer during pregnancy[J]. Lancet Oncol, 2007, 8(1):79-81.
- 22. White TT. Carcinoma of the breast and pregnancy;analysis of 920 cases collected from the literature and 22 new cases[J]. Ann Surg, 1954, 139(1):9-18.
- 23. Dunlop DJ, Soukop M, McEwan HP. Antenatal administration of aminopropylidene diphosphonate[J]. Ann Rheum Dis, 1990, 49(11):955.