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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 326 -331. doi: 10.3877/cma.j.issn.1674-0785.2020.05.002

所属专题： 乳腺疾病； 经典病例； 文献；

乳腺癌·临床研究

妊娠相关性乳腺癌临床病理分析13例
邬茜1, 辛灵1, 刘倩1, 张虹2, 张爽2, 徐玲1, 叶京明1, 段学宁1, 刘荫华1,†()   
  1. 1. 100034　北京大学第一医院乳腺疾病中心
    2. 100034　北京大学第一医院病理科
  • 收稿日期:2020-02-24 出版日期:2020-05-15
  • 通信作者: 刘荫华
  • 基金资助:
    国家重点研发计划（973计划）(2016YFC0901302)

Clinical and pathological characteristics of patients with pregnancy-associated breast cancer: retrospective analysis of 13 cases

Qian Wu1, Ling Xin1, Qian Liu1, Hong Zhang2, Shuang Zhang2, Ling Xu1, Jingming Ye1, Xuening Duan1, Yinhua Liu1,†()   

  1. 1. Breast Disease Center, Peking University First Hospital, Beijing 100034, China
    2. Department of Pathology, Peking University First Hospital, Beijing 100034, China
  • Received:2020-02-24 Published:2020-05-15
  • Corresponding author: Yinhua Liu
  • About author:
    Corresponding author: Liu Yinhua, Email:
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邬茜, 辛灵, 刘倩, 张虹, 张爽, 徐玲, 叶京明, 段学宁, 刘荫华. 妊娠相关性乳腺癌临床病理分析13例[J]. 中华临床医师杂志(电子版), 2020, 14(05): 326-331.

Qian Wu, Ling Xin, Qian Liu, Hong Zhang, Shuang Zhang, Ling Xu, Jingming Ye, Xuening Duan, Yinhua Liu. Clinical and pathological characteristics of patients with pregnancy-associated breast cancer: retrospective analysis of 13 cases[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(05): 326-331.

目的

探讨妊娠相关性乳腺癌的临床病理特征及预后影响因素。

方法

回顾性分析2008年1月至2019年1月北京大学第一医院乳腺疾病中心诊治的妊娠相关性乳腺癌患者的临床资料。

结果

2008年1月至2019年1月北京大学第一医院乳腺疾病中心共收治临床病理资料完整的新发乳腺癌病例4010例，其中13例患者符合妊娠相关乳腺癌诊断标准进入本研究，占全部患者0.32%。参照美国癌症联合会第8版乳腺癌分期标准，13例患者中临床分期Ⅰ期1例，Ⅱ期6例，Ⅲ期4例，Ⅳ期2例；预后分期Ⅰ期3例，Ⅱ期4例，Ⅲ期4例，Ⅳ期2例；分子分型Luminal A型0例，Luminal B型7例，HER-2阳性型3例，三阴型3例。中位随访时间27个月，3年无病生存率88.9%，3年总生存率79.1%。

结论

妊娠相关性乳腺癌临床发病率不高，病期较晚。伴随国家生育政策调整，妊娠相关性乳腺癌发病率可能增高，规范诊治原则至关重要。

关键词: 乳腺肿瘤, 妊娠, 预后, 肿瘤分期
Objective

To investigate the clinical and pathological characteristics of pregnancy-associated breast cancer (PABC) and analyze its prognostic factors .

Methods

We retrospectively analyzed the clinicopathologic features of patients with PABC treated at Peking University First Hospital between January 2008 and January 2019.

Results

Of all 4010 patients included in this study, 13 (0.32%) were diagnosed with PABC. According to American Joint Committee on Cancer staging system, 1 case was clinical stage I, 6 were stage II, 4 were stage Ⅲ, and 2 were stage Ⅳ; 3 cases were prognostic stage I, 4 were stage II, 4 were stage III, and 2 were stage Ⅳ. As for molecular subtype, 7 cases were luminal B, 3 were HER-2 positive, and 3 were triple-negative breast cancer. Most patients had clinicopathological factors that are related to a poor prognosis. The median follow-up duration was 27 months, 3-year overall survival rate was 79.1%, and 3-year disease-free survival rate was 88.9%.

Conclusion

PABC is a rare disease with advanced stage and poor prognosis. As the one-child policy is changing in China, the incidence of PABC tends to increase. Therefore, it is extremely urgent to standardize the treatment of PABC.

Key words: Breast neoplasms, Pregnancy, Prognosis, Neoplasm staging
表1 13例PABC患者的临床病理资料
项目 确诊时间 合计
2008年1月至2016年12月 2017年1月至2019年1月
例数 6（46.2%） 7（53.8%） 13
中位年龄（范围，岁） 33（27~38） 32（25~38） 33（25~38）
发病胎次（例） ? ? ?
? 一胎 3 1 4
? 二胎 3 6 9
确诊时期（例） ? ? ?
? 妊娠期 2 2 4
? 哺乳期 4 5 9
临床分期（例） ? ? ?
? I期 1 0 1
? II期 3 3 6
? III期 2 2 4
? Ⅳ期 0 2 2
预后分期（例） ? ? ?
? I期 2 1 3
? Ⅱ期 2 2 4
? Ⅲ期 2 2 4
? Ⅳ期 0 2 2
组织学分级（例） ? ? ?
? G1 0 1 1
? G2 4 4 8
? G3 2 2 4
分子分型（例） ? ? ?
? Luminal A型 0 0 0
? Luminal B型 4 3 7
? HER-2阳性型 1 2 3
? 三阴型 1 2 3
早期乳腺癌危险度分层（例） ? ? ?
? 低度危险 0 0 0
? 中度危险 3 2 5
? 高度危险 3 3 6
表2 11例早期PABC治疗情况（例）
项目 确诊时间 合计
2008年1月至2016年12月 2017年1月至2019年1月
早期乳腺癌 6 5 11
新辅助化疗 ? ? ?
? 是 5 5 10
? 否 1 0 1
新辅助化疗疗效评价 ? ? ?
? CR及PR 4 4 8
? SD 1 1 2
? PD 0 0 0
手术方式 ? ? ?
? 单纯切除 5 2 7
? 保乳手术 1 1 2
? 单纯切除＋一期重建 0 2 2
Miller-Payne分级 ? ? ?
? G1 0 2 2
? G2 0 0 0
? G3 3 2 5
? G4 1 0 1
? G5 1 1 2
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