Background: Pregnancy-associated breast cancer (PABC), defined as breast cancer diagnosed during pregnancy or within one year postpartum, is a unique and clinically challenging entity. Evidence suggests that tumors diagnosed during pregnancy (PrBC) and postpartum (PPBC) may differ in biology and prognosis. This study compares clinical features, treatment patterns and outcomes between PrBC and PPBC.Methods: We performed a retrospective analysis of 76 women diagnosed with PABC from January 2000 to June 2023 across two tertiary centers. Patients were classified according to ESMO guidelines as PrBC (n= 41) or PPBC (n= 35). Clinical presentation, tumor characteristics, treatment approaches and survival outcomes were evaluated. Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan–Meier analysis and compared with log-rank tests.Results: A total of 76 patients with PABC were included (41 PrBC, 35 PPBC; median age 37 years). Most tumors were high-grade invasive ductal carcinomas, with Luminal B predominant in PrBC and triple-negative breast cancer (TNBC) in PPBC. Locally advanced disease was common (axillary involvement 52%; de novo metastases 9%). Surgery was performed in most cases, with breast conservative surgery (BCS) more frequent in PrBC and mastectomy in PPBC; 46% received neoadjuvant chemotherapy. At median follow-up of 68 months, 7.9% of patients had died and 29% experienced recurrence. Oncologic outcomes were similar between subgroups, with a trend in favor of PrBC. Pregnancy continuation did not adversely affect outcomes.Conclusions: PrBC and PPBC display heterogeneous clinical presentations with a trend toward more favorable outcomes in PrBC. These findings support the need for tailored counseling, individualized management and research designs that differentiate between PrBC and PPBC.
背景：妊娠相关乳腺癌（PABC）定义为妊娠期间或产后一年内诊断的乳腺癌，是一种独特且具有临床挑战性的疾病。有证据表明，妊娠期间诊断的乳腺癌（PrBC）与产后诊断的乳腺癌（PPBC）在生物学特征和预后方面可能存在差异。本研究旨在比较PrBC与PPBC的临床特征、治疗模式及预后结局。 方法：我们对2000年1月至2023年6月期间在两个三级医疗中心诊断为PABC的76例女性患者进行了回顾性分析。根据ESMO指南，患者被分为PrBC组（n=41）和PPBC组（n=35）。评估内容包括临床表现、肿瘤特征、治疗方案及生存结局。采用Kaplan-Meier法估算总生存期（OS）和无病生存期（DFS），并应用对数秩检验进行比较。 结果：共纳入76例PABC患者（PrBC 41例，PPBC 35例；中位年龄37岁）。大多数肿瘤为高级别浸润性导管癌，其中PrBC组以Luminal B型为主，PPBC组以三阴性乳腺癌（TNBC）为主。局部晚期疾病较为常见（腋窝淋巴结受累52%；初诊转移9%）。多数患者接受了手术治疗，其中PrBC组更常采用保乳手术（BCS），而PPBC组更多采用乳房切除术；46%的患者接受了新辅助化疗。中位随访68个月后，7.9%的患者死亡，29%出现复发。两组肿瘤学结局相似，但PrBC组显示出更优的趋势。继续妊娠未对预后产生不良影响。 结论：PrBC与PPBC具有异质性的临床表现，且PrBC的预后呈现更优趋势。这些发现表明，有必要针对PrBC和PPBC进行差异化的个体化咨询、临床管理及研究设计。
肿瘤(癌症)患者之家