Clinical practice guidelines for pregnancy-associated breast cancer:Chinese society of breast surgery(CSBrS)practice guidelines 2021

Pregnancy-associated breast cancer(PABC),including breast cancer during pregnancy(BCP)and postpartum breast cancer(PBC),has become a critical issue for clinicians in consideration of both maternal and offspring safety during diagnosis and treatment.The recommendations in this guideline are mainly based on currently available high-quality prospective studies,retrospective cohort studies,meta-analyses,and guidelines and consensus documents published by internationally recognized or national societies or associations.Clinicians should carefully analyze the potential benefits and risks of each treatment before recommending whether to terminate the pregnancy or lactation,balance the advantages and disadvantages of the treatments,and respect the wishes of patients.

A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008)

Background:Pregnancy-associated breast cancer(PABC)is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth.With the rapid social development and the adjustment of reproductive policies in China,the average age of females at first childbirth is increasing,which is expected to lead to an increase in the incidence of PABC.This study aimed to accumulate clinical experience and to investigate and summarize the prevalence,diagnosis,and treatment of PABC based on large multicenter samples in China.Methods:According to the Chinese Society of Breast Surgery,a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified.The pregnancy status,clinicopathological features,comprehensive treatment methods,and outcomes were retrospectively analyzed.Survival curves were plotted using the Kaplan-Meier method.Results:A total of 164 patients of PABC accounted for 0.30%of the total number of cases in the same period;of which,83 patients were diagnosed during pregnancy and 81 patients during lactation.The median age of PABC was 33 years(24–47 years).Stage Ⅰ patients accounted for 9.1%(15/164),stage Ⅱ 54.9%(90/164),stage Ⅲ 24.4%(40/164),and stage Ⅳ 2.4%(4/164).About 9.1%(15/164)of patients were luminal A.Luminal B patients accounted the most(43.3%[71/164]).About 15.2%(25/164)of patients were human epidermal growth factor receptor 2(Her-2)overexpression and 18.9%(31/164)of patients were triple-negative breast cancer.For pregnancy breast cancer,36.1%(30/83)of patients received direct surgery and 20.5%(17/83)received chemotherapy during pregnancy.About 31.3%(26/83)chose abortion or induction of labor.The median follow-up time was 36 months(3–59 months);11.0%(18/164)patients had local recurrence or distant metastasis and 3.0%(5/164)died.Conclusions:It is safe and feasible to standardize surgery and chemotherapy for PABC.