A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008) / 中华医学杂志(英文版)

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.

Risk factors of underestimating diagnosis with ductal carcinoma in situ following core needle biopsy / 复旦学报（医学版）

Objective To analyze the risk factors of underestimation from core needle biopsy (CNB) diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision.Methods One hundred and fifteen cases of CNB diagnosed DCIS treated in Obstetrics and Gynecology Hospital,Fudan University from Jan.,2010 to Dec.,2016 were analyzed retrospectively.According to postoperative pathological conditions,the cases were divided into underestimation group and non underestimation group.The clinicopathological characteristics of two groups were compared,including age,palpability,tumor diameter,microcalcification,BI-RADS classification and CNB method.Results The overall underestimating rate was 27.0％ (31/115).Univariate analysis found correlation between a palpable lesion,diameter of tumor ＞20 mm,microcalcification,a high BI-RADS classification,use of the 14/16-gauge needle method and underestimation from CNB diagnosed DCIS.Multivariate analysis by Logistic regression showed that diameter of tumor ＞20 mm (OR =0.186,95％CI:0.043-0.810,P =0.025),microcalcification (OR=0.229,95％CI:0.070-0.749,P =0.015),use of the 14/16 gauge needle method (OR =0.171,95 ％ CI:0.043-0.679,P =0.012) were independent risk factors of underestimation from CNB diagnosed DCIS.Conclusions Size of lesion ＞20 mm,microcalcification,use of the 14/16-gauge needle method were independent risk factors of underestimation from CNB diagnosed DCIS.