妊娠相关乳腺癌3例临床病理分析

Clinicopathologic analysis of pregnancy associated breast cancer:3 cases

目的探讨妊娠相关乳腺癌(PABC)的临床及病理特点。方法对渭南市妇幼保健院2018年5月至2019年1月3例PABC患者的临床、病理及免疫组化进行比较,并结合国内外相关文献分析其发病机制及临床特征。结果 3例PABC均为哺乳期乳腺癌,发病中位年龄为34.67岁,肿块体积大,3例均为非特殊性浸润型导管癌Ⅲ级,均伴有淋巴结转移,3例雌激素受体(ER)、孕激素受体(PR)均为阴性,1例人表皮生长因子受体(HER2)表达,增殖指数(Ki67)分别为30%、80%、90%。2例接受新辅助化疗,随访存活,1例未接受新辅助化疗,术后3个月死亡。结论妊娠相关乳腺癌是一种高度恶性肿瘤,预后不良,产前加强乳腺常规检查有其必要性,早期发现及适当的治疗有积极意义。

Objective To investigate the clinical and pathological characteristics of pregnancy associated breast cancer(PABC).Methods The clinical,pathological and immunohistochemical characteristics of 3 patients with PABC were compared,and their pathogenesis and clinical characteristics were analyzed in combination with relevant literatures at home and abroad.Results Three cases of PABC were breast-feeding breast cancer with median age of 34.67 years and large tumor size.Three cases were not special type infiltrating ductal carcinomaⅢlevel,associated with lymph node metastasis.ER and PR of 3 cases were negative,and 1 case expressed HER2.Ki67 indexes were 30%,80%and 90%,respectively.Two patients received neoadjuvant chemotherapy and survived in follow-up.One patient did not receive neoadjuvant chemotherapy and died 3 months after surgery.Conclusion PABC is a highly malignant tumor with poor prognosis.Prenatal routine inspection is necessarily strengthened,which is valuable in early detection and appropriate treatment.