妊娠相关乳腺癌超声表现及病理特征分析

Analysis of clinical features,imaging manifestations and pathological features of pregnancy-associated breast cancer

目的探讨妊娠相关乳腺癌(pregnancy-associated breast cancer,PABC)的临床、超声检查、病理特征,评估其预后情况。方法选取我院确诊的12例PABC患者的临床病史资料,分析其超声检查表现、病理结果及分子分型情况,判断患者的预后及临床转归。结果12例PABC患者均无乳腺癌家族史,均由超声检查首次发现,4例为妊娠期、8例为哺乳期PABC,病变大小平均4.8 cm,范围2.3~7.9 cm,肿块型和非肿块型均占50.00%,肿块型病变中约66.67%具有恶性肿瘤典型特征,病理类型以浸润性导管癌(IDC)为主(91.67%),分子分型以三阴性为主(54.55%)、Her-2(+)次之(27.27%)、Luminal型少见(18.18%)。PABC预后较差,25.00%的患者出现复发或远处转移。结论PABC发病时期特殊、临床特征不典型,早期易漏诊或误诊,超声检查是首选检查方法,准确的BI-RADS分类为患者后期临床诊治提供有效参考依据。

Objective To explore the clinical,imaging,and pathological characteristics of pregnancy-associated breast cancer(PABC),and to evaluate its prognosis.Methods We retrospectively analyzed the clinical history data of 12 PABC patients diagnosed in our hospital,studied their imaging manifestations,pathological results and molecular typing,and determined the prognosis and clinical outcome of the patients.Results None of the 12 patients had a family history of breast cancer.All were found for the first time by ultrasound examination.4 cases were pregnant and 8 cases were lactating.The average size of the lesion was 4.8 cm,the range was 2.3~7.9 cm.Tumor type and non-lump type accounted for 50.00%.About 66.67%of mass lesions had typical characteristics of malignant tumors.The pathological type was mainly invasive ductal carcinoma(IDC)(91.67%),and the molecular type was mainly triple-negative(54.55%),Her-2(+)followed by(27.27%),luminal type was rare(18.18%).The prognosis was poor,with 25%of patients experiencing recurrence or distant metastasis.Conclusion The onset period of PABC is special,the clinical features are atypical,and it is easy to be missed or misdiagnosed in the early stage.Ultrasound is the preferred examination method.The accurate BI-RADS classification provides effective reference for the later clinical management of patients.