妊娠相关乳腺癌预后的Meta分析
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摘要
目的比较妊娠相关乳腺癌(pregnancy associated breast cancer, PABC)和非妊娠相关乳腺癌(non-pregnancy associated breast cancer,non-PABC)的病死率(case-fatality rate,CFR)和复发率(relapse rate, RR)差异,以及探究造成差异的可能因素以期改善患者的预后。方法检索MEDLINE(PubMed)数据库、中国知网(CNKI)数据库、万方数据库、维普数据库,收集在怀孕期间或之后1年内诊断乳腺癌患者的研究文献,并使用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)来进行文献质量评价,数据分析采用RevMan5.3软件,计算合并危险比值比(odds ratio,OR)及95%可信区间(CI)并对发表偏倚进行评估。结果 23篇文献纳入病死率对比的Meta分析(PABC组1 999例,non-PABC组13 271例)结果显示:与non-PABC组相比,PABC组的病死风险更高(OR=1.46,95%CI:1.31-1.63;P=0.40,I~( 2)=5%)。5篇文献纳入复发率对比的Meta分析(PABC组188例,non-PABC组493例)结果显示:与non-PABC组相比,PABC组的复发风险也更高(OR=2.10,95%CI:1.45-3.04;P=0.30,I~2=18%)。漏斗图均提示不存在发表偏倚。结论 PABC患者相对non-PABC患者的预后更差。
Objective To compare the case-fatality rate(CFR) and relapse rate(RR) between patients with pregnancy-associated breast cancer(PABC) and non-PABC and explore the possible factors contributing to such differences. Methods We searched the online databases including PubMed, CNKI, Wanfang, and VIP for case-control or cohort studies describing the outcomes of patients with breast cancer diagnosed during or within 1 year after pregnancy. The Newcastle-Ottawa Scale(NOS) was used for literature quality evaluation. The odds ratio(OR) and 95% confidence interval(95% CI) were calculated using RevMan5.3, and the publication bias of the retrieved articles was evaluated. Results We retrieved 23 articles that compared the CFR between patients with PABC(n=1 999) and non-PABC(n=13 271). The results of meta-analysis showed that the patients with PABC had a significantly higher CFR than those with non-PABC(OR=1.46, 95% CI: 1.31-1.63; P=0.40, I~( 2)=5%). Meta-analysis of 5 articles that compared the RR between patients with PABC(n=188) and non-PABC(n=493) showed that the patients with PABC had a significantly higher RR than those with non-PABC(OR=2.10, 95%CI: 1.45-3.04; P=0.30, I~2=18%). The funnel plots indicated no publication bias in all the articles included in this analysis. Conclusion The patients with PABC have a poorer prognosis than those with non-PABC.
Objective To compare the case-fatality rate(CFR) and relapse rate(RR) between patients with pregnancy-associated breast cancer(PABC) and non-PABC and explore the possible factors contributing to such differences. Methods We searched the online databases including PubMed, CNKI, Wanfang, and VIP for case-control or cohort studies describing the outcomes of patients with breast cancer diagnosed during or within 1 year after pregnancy. The Newcastle-Ottawa Scale(NOS) was used for literature quality evaluation. The odds ratio(OR) and 95% confidence interval(95% CI) were calculated using RevMan5.3, and the publication bias of the retrieved articles was evaluated. Results We retrieved 23 articles that compared the CFR between patients with PABC(n=1 999) and non-PABC(n=13 271). The results of meta-analysis showed that the patients with PABC had a significantly higher CFR than those with non-PABC(OR=1.46, 95% CI: 1.31-1.63; P=0.40, I~( 2)=5%). Meta-analysis of 5 articles that compared the RR between patients with PABC(n=188) and non-PABC(n=493) showed that the patients with PABC had a significantly higher RR than those with non-PABC(OR=2.10, 95%CI: 1.45-3.04; P=0.30, I~2=18%). The funnel plots indicated no publication bias in all the articles included in this analysis. Conclusion The patients with PABC have a poorer prognosis than those with non-PABC.
引文
[1] AMANT F, LOIBL S, NEVEN P, et al. Breast cancer in pregnancy[J]. Lancet, 2012,379(9815): 570-579. DOI: 10.1016/S0140-6736(11)61092-1.
[2] KAKOULIDIS I, SKAGIAS L, POLITI E. Pregnancy associated breast cancer (PABC): Aspects in diagnosis[J]. Breast Dis, 2015, 35(3): 157-166. DOI: 10.3233/BD-150408.
[3] NAVROZOGLOU I, VREKOUSSIS T, KONTOSTOLIS E, et al. Breast cancer during pregnancy: a mini-review[J]. Eur J Surg Oncol, 2008, 34(8): 837-843. DOI: 10.1016/j.ejso.2008.01.029.
[4] 张杰, 费菲, 邵志敏,等. 妊娠哺乳期乳腺癌的配对资料分析[J].上海医学,2003,26(2): 124-126. DOI: 10.3969/j.issn.0253-9934.2003.02.014. ZHANG J, FEI F, SHAO Z M, et al.A pairing control analysis of pregnancy associated with breast cancer[J]. Shanghai Med J, 2003, 26(2): 124-126. DOI: 10.3969/j.issn.0253-9934.2003.02.014.
[5] 马田雨, 代文杰. 妊娠期乳腺癌诊断及治疗进展[J]. 中国实用外科杂志, 2014, 34(4): 376-378. MA T Y, DAI W J. Progress in diagnosis and treatment of pregnancy associated with breast cancer[J]. Chin J Pract Surg, 2014, 34(4): 376-378.
[6] AZIZ S, PERVEZ S, KHAN S, et al. Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma[J]. Pathol Res Pract, 2003, 199(1): 15-21. DOI: 10.1078/0344-0338-00347.
[7] SIEGELMANN-DANIELI N, TAMIR A, ZOHAR H, et al. Breast cancer in women with recent exposure to fertility medications is associated with poor prognostic features[J]. Breast, 2003, 14(9): 1031-1038. DOI: 10.1245/ aso.2003.03.068.
[8] 毛杰, 海健, 刘少华,等. 妊娠期哺乳期乳腺癌12例临床分析[J]. 中国普通外科杂志, 2005, 14(4): 18. DOI: 10.3969/j.issn.1005-6947.2005.04.018. MAO J, HAI J, LIU S H, et al. Clinical analysis of 12 cases of pregnancy associated with breast cancer[J]. Chin J Gen Surg, 2005, 14(4): 18. DOI: 10.3969/j.issn.1005-6947.2005.04.018.
[9] 余文杰, 曹飞麟, 沈超君. 妊娠期哺乳期乳腺癌9例临床分析[J]. 福建医药杂志, 2007, 29(3): 85-86. DOI: 10.3969/j.issn.1002-2600.2007.03.060. YU W J, CAO F L, SHEN C J. Clinical analysis of 9 cases of pregnancy associated with breast cancer[J]. Fujian J Med, 2007, 29(3): 85-86. DOI: 10.3969/j.issn.1002-2600.2007.03.060.
[10] 杨丽萍, 马行天, 万向华,等. 妊娠哺乳期乳腺癌20例临床分析[J]. 中国肿瘤临床与康复, 2007, 14(5): 444-445. DOI: 10.3969/j.issn.1005-8664.2007.05.022. YANG L P, MA X T, WAN X H, et al. Analysis of 20 cases of breast cancer during pregnancy and lactation[J]. Chin J Clin Oncol Rehabil,2007,14(5): 444-445. DOI: 10.3969/j.issn.1005-8664.2007.05.022.
[11] RODRIGUEZ A O, CHEW H, CRESS R, et al. Evidence of poorer survival in pregnancy-associated breast cancer[J]. Obstet Gynecol, 2008, 112(1): 71-78. DOI: 10.1097/AOG.0b013e31817c4ebc.
[12] 韩继龙, 秦德民, 王国鑫,等. 妊娠哺乳期乳腺癌13例临床诊治体会[J]. 中国现代医生, 2008, 46(16): 156. DOI: 10.3969/j.issn.1673-9701.2008.16.095. HAN J L, QIN D M, WANG G X, et al. Clinical diagnosis and treatment of 13 cases of breast cancer during pregnancy and lactation[J]. China Modern Doct, 2008, 46(16): 156. DOI: 10.3969/j.issn.1673-9701.2008.16.095.
[13] MATHELIN C, ANNANE K, TREISSER A, et al. Pregnancy and post-partum breast cancer: a prospective study[J]. Anticancer Res, 2008, 28(4C): 2447-2452.
[14] BEADLE B M, WOODWARD W A, MIDDLETON L P, et al. The impact of pregnancy on breast cancer outcomes in women [15] 张玫吉, 李长立, 葛亮. 妊娠期及哺乳期乳腺癌8例临床分析[J]. 中国现代药物应用, 2009, 3(16): 149-150. DOI: 10.3969/j.issn.1673-9523.2009.16.120. ZHANG M J, LI C L, GE L. Clinical analysis of 8 cases of breast cancer during pregnancy and lactation[J]. Chin J Mod Drug Appl, 2009, 3(16): 149-150. DOI: 10.3969/j.issn.1673-9523.2009.16.120.
[16] MOREIRA W B, BRAND?O E C, SOARES A N, et al. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study[J]. Sao Paulo Med J, 2010, 128(3): 119-124. DOI: 10.1590/s1516-31802010000300003.
[17] ALI S A, GUPTA S, SEHGAL R, et al. Survival outcomes in pregnancy associated breast cancer: a retrospective case control study[J]. Breast J, 2012,18(2): 139-144. DOI: 10.1111/j.1524-4741.2011.01201.x.
[18] AZIM H A JR, BOTTERI E, RENNE G, et al. The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study[J]. Acta Oncol, 2012, 51(5): 653. DOI: 10.3109/0284186X.2011.636069.
[19] DIMITRAKAKIS C, ZAGOURI F, TSIGGINOU A, et al. Does pregnancy-associated breast cancer imply a worse prognosis? A matched case-case study[J]. Breast Care, 2013, 8(3): 203-207. DOI: 10.1159/000352093.
[20] BAULIES S, CUSIDó M, TRESSERRA F, et al. Pregnancy-associated breast cancer: an analytical observational study[J]. Med Clin(Barc), 2014, 142(5): 200-204. DOI: 10.1016/j.medcli.2012.12.020.
[21] SáNCHEZ C, ACEVEDO F, MEDINA L, et al. Breast cancer and pregnancy: a comparative analysis of a Chilean cohort[J]. Ecancermedicalscience, 2014, 8(1): 434. DOI: 10.3332/ecancer.2014.434.
[22] YANG Y L, CHAN K A, HSIEH F J, et al. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival[J]. PLoS ONE, 2014, 9(11): e111934. DOI: 10.1371/journal.pone.0111934.
[23] GENIN A S, DE R Y, STEVENS D, et al. Association with pregnancy increases the risk of local recurrence but does not impact overall survival in breast cancer: A case-control study of 87 cases[J]. Breast, 2016, 30: 222-227. DOI: 10.1016/j.breast.2015.09.006.
[24] 吴尚谕. 妊娠相关乳腺癌的临床特点及预后分析[D]. 乌鲁木齐: 新疆医科大学, 2016. WU S Q.The clinical features and prognosis of pregnancy-associated breast cancer [D]. Urumchi: Xinjiang Medical University, 2016.
[25] 杜江,钟红,马斌林.22例妊娠哺乳期乳腺癌的临床研究[J].中华肿瘤防治杂志,2016: 86-87. DOI: 10.16073/j.cnki.cjcpt.20170704.017. DU J, ZHONG H, MA B L. Clinical study of 22 cases of breast cancer during pregnancy and lactation [J]. Chin J Cancer Prev Treat, 2016: 86-87. DOI: 10.16073/j.cnki.cjcpt.20170704.017.
[26] KIM Y G, JEON Y W, KO B K, et al. Clinicopathologic characteristics of pregnancy-associated breast cancer: results of analysis of a nationwide breast cancer registry database[J]. J Breast Cancer, 2017, 20(3): 264-269. DOI: 10.4048/jbc.2017.20.3.264.
[27] BAE S Y, JUNG S P, JUNG E S, et al. Clinical characteristics and prognosis of pregnancy-associated breast cancer: poor survival of luminal B subtype[J]. Oncology, 2018, 95(3): 1-7. DOI: 10.1159/000488944.
[28] GORINS A, LENHARDT F, ESPIE M. Breast cancer during pregnancy. Epidemiology-diagnosis-prognosis[J]. Contracept Fertil Sex, 1996, 24(2): 153-156.
[29] LETHABY A E, O’NEILL M A, MASON B H, et al. Overall survival from breast cancer in women pregnant or lactating at or after diagnosis. Auckland Breast Cancer Study Group[J]. Int J Cancer, 1996, 67(6): 751-755. DOI: 10.1002/(SICI)1097-0215(19960917)67: 6<751: : AID-IJC1>3.0.CO; 2-Q.
[30] COLLEONI M, ROTMENSZ N, PERUZZOTTI G, et al. Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease[J]. Ann Oncol, 2006, 17(10): 1497-1503. DOI: 10.1093/anonc/mdl145.
[31] MHUIREACHTAIGH R N, O’GORMAN D A. Anesthesia in pregnant patients for nonobstetric surgery[J]. J Clin Anesthesia, 2006, 18(1): 60-66. DOI: 10.1016/j.jclinane.2004.11.009.
[32] 吕勇刚, 凌瑞. 妊娠期乳腺癌的诊治及预后[J]. 中华乳腺病杂志(电子版), 2014, 8(5): 306-309. DOI: 10.3877/cma.j.issn.1674-0807.2014.05.002. LYU Y G, LING R. Diagnosis, treatment and prognosis of breast cancer during pregnancy[J]. Chin J Breast Dis (Electr Vers), 2014, 8(5): 306-309. DOI: 10.3877/cma.j.issn.1674-0807.2014.05.002.
[33] 李俊杰, 邵志敏. 妊娠期乳腺癌的诊治进展[J]. 中国癌症杂志, 2007, 17(10): 824-827. DOI: 10.3969/j.issn.1007-3639.2007.10.017. LI J J, SHAO Z M. Advances in the diagnosis and management of pregnancy associated breast cancer[J]. China Oncol, 2007, 17(10): 824-827.DOI: 10.3969/j.issn.1007-3639.2007.10.017.
[34] 黄元坤, 周蕾蕾. 妊娠期乳腺癌的诊断和治疗现状[J]. 中国普外基础与临床杂志, 2013,20(8): 862-866. HUANG Y K, ZHOU L L. Diagnosis and treatment for pregnancy-associated breast cancer[J]. Chin J Bases Clin Gen Surg, 2013,20(8): 862-866.
[2] KAKOULIDIS I, SKAGIAS L, POLITI E. Pregnancy associated breast cancer (PABC): Aspects in diagnosis[J]. Breast Dis, 2015, 35(3): 157-166. DOI: 10.3233/BD-150408.
[3] NAVROZOGLOU I, VREKOUSSIS T, KONTOSTOLIS E, et al. Breast cancer during pregnancy: a mini-review[J]. Eur J Surg Oncol, 2008, 34(8): 837-843. DOI: 10.1016/j.ejso.2008.01.029.
[4] 张杰, 费菲, 邵志敏,等. 妊娠哺乳期乳腺癌的配对资料分析[J].上海医学,2003,26(2): 124-126. DOI: 10.3969/j.issn.0253-9934.2003.02.014. ZHANG J, FEI F, SHAO Z M, et al.A pairing control analysis of pregnancy associated with breast cancer[J]. Shanghai Med J, 2003, 26(2): 124-126. DOI: 10.3969/j.issn.0253-9934.2003.02.014.
[5] 马田雨, 代文杰. 妊娠期乳腺癌诊断及治疗进展[J]. 中国实用外科杂志, 2014, 34(4): 376-378. MA T Y, DAI W J. Progress in diagnosis and treatment of pregnancy associated with breast cancer[J]. Chin J Pract Surg, 2014, 34(4): 376-378.
[6] AZIZ S, PERVEZ S, KHAN S, et al. Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma[J]. Pathol Res Pract, 2003, 199(1): 15-21. DOI: 10.1078/0344-0338-00347.
[7] SIEGELMANN-DANIELI N, TAMIR A, ZOHAR H, et al. Breast cancer in women with recent exposure to fertility medications is associated with poor prognostic features[J]. Breast, 2003, 14(9): 1031-1038. DOI: 10.1245/ aso.2003.03.068.
[8] 毛杰, 海健, 刘少华,等. 妊娠期哺乳期乳腺癌12例临床分析[J]. 中国普通外科杂志, 2005, 14(4): 18. DOI: 10.3969/j.issn.1005-6947.2005.04.018. MAO J, HAI J, LIU S H, et al. Clinical analysis of 12 cases of pregnancy associated with breast cancer[J]. Chin J Gen Surg, 2005, 14(4): 18. DOI: 10.3969/j.issn.1005-6947.2005.04.018.
[9] 余文杰, 曹飞麟, 沈超君. 妊娠期哺乳期乳腺癌9例临床分析[J]. 福建医药杂志, 2007, 29(3): 85-86. DOI: 10.3969/j.issn.1002-2600.2007.03.060. YU W J, CAO F L, SHEN C J. Clinical analysis of 9 cases of pregnancy associated with breast cancer[J]. Fujian J Med, 2007, 29(3): 85-86. DOI: 10.3969/j.issn.1002-2600.2007.03.060.
[10] 杨丽萍, 马行天, 万向华,等. 妊娠哺乳期乳腺癌20例临床分析[J]. 中国肿瘤临床与康复, 2007, 14(5): 444-445. DOI: 10.3969/j.issn.1005-8664.2007.05.022. YANG L P, MA X T, WAN X H, et al. Analysis of 20 cases of breast cancer during pregnancy and lactation[J]. Chin J Clin Oncol Rehabil,2007,14(5): 444-445. DOI: 10.3969/j.issn.1005-8664.2007.05.022.
[11] RODRIGUEZ A O, CHEW H, CRESS R, et al. Evidence of poorer survival in pregnancy-associated breast cancer[J]. Obstet Gynecol, 2008, 112(1): 71-78. DOI: 10.1097/AOG.0b013e31817c4ebc.
[12] 韩继龙, 秦德民, 王国鑫,等. 妊娠哺乳期乳腺癌13例临床诊治体会[J]. 中国现代医生, 2008, 46(16): 156. DOI: 10.3969/j.issn.1673-9701.2008.16.095. HAN J L, QIN D M, WANG G X, et al. Clinical diagnosis and treatment of 13 cases of breast cancer during pregnancy and lactation[J]. China Modern Doct, 2008, 46(16): 156. DOI: 10.3969/j.issn.1673-9701.2008.16.095.
[13] MATHELIN C, ANNANE K, TREISSER A, et al. Pregnancy and post-partum breast cancer: a prospective study[J]. Anticancer Res, 2008, 28(4C): 2447-2452.
[14] BEADLE B M, WOODWARD W A, MIDDLETON L P, et al. The impact of pregnancy on breast cancer outcomes in women
[16] MOREIRA W B, BRAND?O E C, SOARES A N, et al. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study[J]. Sao Paulo Med J, 2010, 128(3): 119-124. DOI: 10.1590/s1516-31802010000300003.
[17] ALI S A, GUPTA S, SEHGAL R, et al. Survival outcomes in pregnancy associated breast cancer: a retrospective case control study[J]. Breast J, 2012,18(2): 139-144. DOI: 10.1111/j.1524-4741.2011.01201.x.
[18] AZIM H A JR, BOTTERI E, RENNE G, et al. The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study[J]. Acta Oncol, 2012, 51(5): 653. DOI: 10.3109/0284186X.2011.636069.
[19] DIMITRAKAKIS C, ZAGOURI F, TSIGGINOU A, et al. Does pregnancy-associated breast cancer imply a worse prognosis? A matched case-case study[J]. Breast Care, 2013, 8(3): 203-207. DOI: 10.1159/000352093.
[20] BAULIES S, CUSIDó M, TRESSERRA F, et al. Pregnancy-associated breast cancer: an analytical observational study[J]. Med Clin(Barc), 2014, 142(5): 200-204. DOI: 10.1016/j.medcli.2012.12.020.
[21] SáNCHEZ C, ACEVEDO F, MEDINA L, et al. Breast cancer and pregnancy: a comparative analysis of a Chilean cohort[J]. Ecancermedicalscience, 2014, 8(1): 434. DOI: 10.3332/ecancer.2014.434.
[22] YANG Y L, CHAN K A, HSIEH F J, et al. Pregnancy-associated breast cancer in Taiwanese women: potential treatment delay and impact on survival[J]. PLoS ONE, 2014, 9(11): e111934. DOI: 10.1371/journal.pone.0111934.
[23] GENIN A S, DE R Y, STEVENS D, et al. Association with pregnancy increases the risk of local recurrence but does not impact overall survival in breast cancer: A case-control study of 87 cases[J]. Breast, 2016, 30: 222-227. DOI: 10.1016/j.breast.2015.09.006.
[24] 吴尚谕. 妊娠相关乳腺癌的临床特点及预后分析[D]. 乌鲁木齐: 新疆医科大学, 2016. WU S Q.The clinical features and prognosis of pregnancy-associated breast cancer [D]. Urumchi: Xinjiang Medical University, 2016.
[25] 杜江,钟红,马斌林.22例妊娠哺乳期乳腺癌的临床研究[J].中华肿瘤防治杂志,2016: 86-87. DOI: 10.16073/j.cnki.cjcpt.20170704.017. DU J, ZHONG H, MA B L. Clinical study of 22 cases of breast cancer during pregnancy and lactation [J]. Chin J Cancer Prev Treat, 2016: 86-87. DOI: 10.16073/j.cnki.cjcpt.20170704.017.
[26] KIM Y G, JEON Y W, KO B K, et al. Clinicopathologic characteristics of pregnancy-associated breast cancer: results of analysis of a nationwide breast cancer registry database[J]. J Breast Cancer, 2017, 20(3): 264-269. DOI: 10.4048/jbc.2017.20.3.264.
[27] BAE S Y, JUNG S P, JUNG E S, et al. Clinical characteristics and prognosis of pregnancy-associated breast cancer: poor survival of luminal B subtype[J]. Oncology, 2018, 95(3): 1-7. DOI: 10.1159/000488944.
[28] GORINS A, LENHARDT F, ESPIE M. Breast cancer during pregnancy. Epidemiology-diagnosis-prognosis[J]. Contracept Fertil Sex, 1996, 24(2): 153-156.
[29] LETHABY A E, O’NEILL M A, MASON B H, et al. Overall survival from breast cancer in women pregnant or lactating at or after diagnosis. Auckland Breast Cancer Study Group[J]. Int J Cancer, 1996, 67(6): 751-755. DOI: 10.1002/(SICI)1097-0215(19960917)67: 6<751: : AID-IJC1>3.0.CO; 2-Q.
[30] COLLEONI M, ROTMENSZ N, PERUZZOTTI G, et al. Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease[J]. Ann Oncol, 2006, 17(10): 1497-1503. DOI: 10.1093/anonc/mdl145.
[31] MHUIREACHTAIGH R N, O’GORMAN D A. Anesthesia in pregnant patients for nonobstetric surgery[J]. J Clin Anesthesia, 2006, 18(1): 60-66. DOI: 10.1016/j.jclinane.2004.11.009.
[32] 吕勇刚, 凌瑞. 妊娠期乳腺癌的诊治及预后[J]. 中华乳腺病杂志(电子版), 2014, 8(5): 306-309. DOI: 10.3877/cma.j.issn.1674-0807.2014.05.002. LYU Y G, LING R. Diagnosis, treatment and prognosis of breast cancer during pregnancy[J]. Chin J Breast Dis (Electr Vers), 2014, 8(5): 306-309. DOI: 10.3877/cma.j.issn.1674-0807.2014.05.002.
[33] 李俊杰, 邵志敏. 妊娠期乳腺癌的诊治进展[J]. 中国癌症杂志, 2007, 17(10): 824-827. DOI: 10.3969/j.issn.1007-3639.2007.10.017. LI J J, SHAO Z M. Advances in the diagnosis and management of pregnancy associated breast cancer[J]. China Oncol, 2007, 17(10): 824-827.DOI: 10.3969/j.issn.1007-3639.2007.10.017.
[34] 黄元坤, 周蕾蕾. 妊娠期乳腺癌的诊断和治疗现状[J]. 中国普外基础与临床杂志, 2013,20(8): 862-866. HUANG Y K, ZHOU L L. Diagnosis and treatment for pregnancy-associated breast cancer[J]. Chin J Bases Clin Gen Surg, 2013,20(8): 862-866.