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目的 :研究妊娠期乳腺癌在诊断和手术、化疗、放疗综合治疗方面的特殊性。方法 :1992年 12月—1999年 6月 ,法国巴黎第十二大学附属HenriMondor医院放疗科收治 9例妊娠期乳腺癌患者 ,其中 3例诊断于妊娠期 ,6例诊断于分娩后 1年内。 5例行乳房保留治疗 ,4例改良根治术。所有病例行术后放疗。 7例接受化疗。结果 :9例钼靶摄片中 7例和所有的 5例超声检查提示肿瘤征象 ,诊断时总体病期晚 ,Ⅰ、Ⅱ、、Ⅲ期比例分别为11%、44 %和 44 %。中位随访 6 0月 (9— 89月 )时 ,6例无病生存 ,3例在治疗结束后 14月— 48月出现局部复发或远处转移。结论 :妊娠期乳腺癌诊断延误较为常见 ,对分娩后确诊的患者 ,应重视妊娠、哺乳期乳房体检和超声检查在鉴别诊断乳房肿块中的作用。治疗原则必须兼顾疾病的迫切性和胎儿的安全性。在可以及时开展化疗和放疗的综合治疗的前提下 ,乳房保留治疗在早期妊娠期乳腺癌中是可行的
Objectives: To study the specificity of diagnosis and surgical, chemotherapy, and radiotherapy for gestational breast cancer. METHODS: From December 1992 to June 1999, nine patients with breast cancer during pregnancy were admitted to the Radiotherapy Department of Henri Mondor Hospital, University of Paris, France. Three cases were diagnosed during pregnancy and six cases were diagnosed within one year after delivery. Five patients underwent breast retention therapy and four patients underwent modified radical mastectomy. Postoperative radiotherapy was performed in all cases. Seven patients received chemotherapy. RESULTS: Seven of the 9 molybdenum targets and 5 of 5 ultrasounds all showed signs of tumor. The overall disease duration was late at the time of diagnosis. The proportions of stage I, II, and III were 11%, 44%, and 44%, respectively. During the median follow-up period of June (9-89 months), 6 cases survived without disease, and 3 cases showed local recurrence or distant metastasis from the 14th to the 48th month after the end of treatment. Conclusion: The diagnosis delay of breast cancer during pregnancy is more common. For patients diagnosed after delivery, attention should be paid to the role of pregnancy breast-feeding breast examination and ultrasound examination in the differential diagnosis of breast lumps. The principle of treatment must take into account the urgency of the disease and the safety of the fetus. Breast preserving therapy is feasible in the early stage of gestational breast cancer under the premise of timely comprehensive treatment of chemotherapy and radiotherapy.