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Long-term Safety of Pregnancy Following Breast Cancer According to Estrogen Receptor Status
Journal of the National Cancer Institute ( IF 9.9 ) Pub Date : 2017-10-26 , DOI: 10.1093/jnci/djx206
Matteo Lambertini 1 , Niels Kroman 2 , Lieveke Ameye 3 , Octavi Cordoba 4 , Alvaro Pinto 5 , Giovanni Benedetti 6 , Maj-Britt Jensen 7 , Shari Gelber 8 , Maria Del Grande 9 , Michail Ignatiadis 1 , Evandro de Azambuja 1 , Marianne Paesmans 3 , Fedro A Peccatori 10 , Hatem A Azim 9
Affiliation  

Safety of pregnancy in women with history of estrogen receptor (ER)–positive breast cancer remains controversial. In this multicenter case–control study, 333 patients with pregnancy after breast cancer were matched (1:3) to 874 nonpregnant patients of similar characteristics, adjusting for guaranteed time bias. Survival estimates were calculated using the Kaplan-Meier analysis; groups were compared with the log-rank test. All reported P values were two-sided. At a median follow-up of 7.2 years after pregnancy, no difference in disease-free survival was observed between pregnant and nonpregnant patients with ER-positive (hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.70 to 1.26, P = .68) or ER-negative (HR = 0.75, 95% CI = 0.53 to 1.06, P = .10) disease. No overall survival (OS) difference was observed in ER-positive patients (HR = 0.84, 95% CI = 0.60 to 1.18, P = .32); ER-negative patients in the pregnant cohort had better OS (HR = 0.57, 95% CI = 0.36 to 0.90, P = .01). Abortion, time to pregnancy, breastfeeding, and type of adjuvant therapy had no impact on patients’ outcomes. This study provides reassuring evidence on the long-term safety of pregnancy in breast cancer survivors, including those with ER-positive disease.

中文翻译:

根据雌激素受体状态确定乳腺癌后妊娠的长期安全性

有雌激素受体(ER)阳性乳腺癌病史的女性怀孕的安全性仍然存在争议。在这项多中心病例对照研究中,将 333 名乳腺癌后妊娠患者与 874 名具有相似特征的非妊娠患者进行匹配 (1:3),并调整了保证时间偏差。使用 Kaplan-Meier 分析计算生存估计值;组间比较采用对数秩检验。所有报告的P值都是双向的。在怀孕后 7.2 年的中位随访中,ER 阳性的怀孕和非怀孕患者之间没有观察到无病生存率的差异(风险比 [HR] = 0.94,95% 置信区间 [CI] = 0.70 至 1.26) ,P = .68)或 ER 阴性(HR = 0.75,95% CI = 0.53 至 1.06,P = .10)疾病。ER 阳性患者中未观察到总生存期 (OS) 差异(HR = 0.84,95% CI = 0.60 至 1.18,P = .32);妊娠队列中 ER 阴性患者的 OS 较好(HR = 0.57,95% CI = 0.36 至 0.90,P = 0.01)。流产、怀孕时间、母乳喂养和辅助治疗类型对患者的结果没有影响。这项研究为乳腺癌幸存者(包括 ER 阳性患者)怀孕的长期安全性提供了令人放心的证据。
更新日期:2017-10-26
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