Gebelikle İlişkili Meme Kanserli 16 Hastaya Dair Tek Merkez Çalışması: Klinikopatolojik Özellikler ve Sağkalım

Amaç: Gebelikte kanser tedavisi hem anne hem de bebek sağlığı açısından özel bir öneme sahiptir. Günümüzde kadınların gebeliği ileri yaşlara ertelemesi ve meme kanseri tedavisi almakta olan kadınların gebelik isteği nedeniyle GİMK tedavisi giderek önem kazanmaktadır. Bu retrospektif çalışma ile uzun süreli izlemi olan vakaların klinik, radyolojik ve histopatolojik özelliklerini ve GİMK tedavisi sonuçlarını incelemek amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya GİMK tanısı almış olan 16 kadın hasta dahil edilmiştir. 2010–2017 döneminde İstanbul Üniversitesi Onkoloji Enstitüsünde gebelik sırasında veya postnatal birinci yılda meme kanseri tanısıyla tedavi ve takip edilen hastaların klinikopatolojik özellikleri, gestasyonel öyküleri ve sağkalım sonuçları değerlendirilmiştir. Bulgular: Medyan hasta yaşı 32 (21–41) yıldı. Gebe hastaların tanı anındaki medyan gebelik haftası 26 (11–35) hafta iken postpartum hastalarda doğumdan sonra meme kanseri tanısına kadar geçen ortalama süre 9,3 (±3,6) ay idi. Medyan takip süresi 47,5 (5–99) aydı. Medyan genel sağkalım (GS) ve hastalıksız sağkalım (HS) değerlerine ulaşılamadığı için ortalama GS ve HS hesaplandı. Ortalama GS ve HS değerleri sırasıyla 87,8±7,3 ve 77,6±8,5 ay idi. Tartışma ve Sonuç: Gebelikte meme kanseri takip ve tedavisi multidisipliner bir ekip tarafından yapılması gereken özel bir sağlık sorunudur. Primer cerrahi müdahale geciktirilmemelidir. Kemoterapi ikinci ve üçüncü trimesterde güvenle uygulanabilirken radyoterapi, hedefe yönelik tedaviler ve endokrin tedavileri doğum sonrasına ertelenmelidir. Gebelik ve kanser birlikteliği vakalarının bildirilmesi ve uzun süreli takibi ilgili bilgi birikiminin artması bakımından çok önemlidir.

A One-center Study of Sixteen Patients with Pregnancy-associated Breast Cancer: Clinicopathological Characteristics and Survival

Aim: Cancer treatment is of special importance during pregnancy, concerning the health of bothmother and baby. Treatment of pregnancy-associated breast cancer (PABC) has become even moreimportant today because women tend to delay pregnancy to later ages and because of women whodesire to conceive while under treatment for breast cancer. This retrospective study is aimed at investigatingthe clinical, radiological and histopathological characteristics and PABC treatment outcomesof patients who had long-term follow-up.Materials and Methods: Sixteen women diagnosed with PABC were included in this study. We evaluatedthe clinicopathological characteristics, gestational history, and survival outcomes of the patientswho had been treated and followed up for breast cancer during pregnancy and the first postnatal yearat Istanbul University Institute of Oncology in 2010–2017.Results: The median patient age was 32 (21–41) years. The median gestational week of diagnosis inpregnant patients was 26 (11–35) weeks while the mean time elapsed after delivery until diagnosis inpostpartum patients was 9.3 (±3.6) months. The median follow-up time was 47.5 (5–99) months. Themean disease-free survival (DFS) and overall survival (OS) were calculated because the median DFSand OS could not be computed. The mean OS and DFS values were 87.8±7.3 and 77.6±8.5 months,respectively.Discussion and Conclusion: Breast cancer in pregnancy is a special health condition that shouldbe treated and followed up by a multidisciplinary team. Primary surgical intervention should not bedelayed. While chemotherapy could be administered safely in the first and second trimesters, radiotherapyand targeted and endocrine treatments should be postponed until after delivery. Reportingand long-term follow-up of cases of pregnancy and cancer concurrence is essential for increasingthe relevant knowledge.

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