妊娠相关性乳腺癌合并多种并发症一例报告

A Case Report of Pregnancy-Associated Breast Cancer Complicated with Multiple Comorbidities

摘要: 本文报道1例36岁G1P0孕37 + 5周女性患者，既往有脊髓灰质炎后遗症及营养不良史，因左乳巨大实性肿物伴腋窝淋巴结肿大半天入院，同时合并右肾重度积水、中度贫血。经多学科会诊评估，行剖宫产术后即刻乳腺穿刺活检，病理确诊为III级浸润性导管癌(Luminal B型)。患者基础状况差，术后予卵巢功能抑制剂联合选择性雌激素受体调节剂内分泌治疗。出院后失访，仅电话随访自述左乳肿块略缩小、疼痛可耐受，肿瘤疗效及手术可切除性有待进一步评估。合并严重基础疾病与多系统受累的妊娠期相关乳腺癌，采用个体化多学科协作诊疗，是保障母婴安全、改善预后的关键，可为复杂妊娠合并恶性肿瘤的临床处置提供参考。

Abstract: This paper reports a 36-year-old G1P0 female patient at 37 + 5 weeks of gestation, with a history of poliomyelitis sequelae and malnutrition. She was admitted due to a huge solid mass in the left breast with axillary lymphadenopathy for half a day, accompanied by severe right hydronephrosis and moderate anemia. After multidisciplinary team (MDT) evaluation, cesarean section was performed followed by immediate breast core-needle biopsy. Pathology confirmed grade III invasive ductal carcinoma (Luminal B type). Given her poor general condition, the patient received endocrine therapy combining ovarian function suppression (OFS) with a selective estrogen receptor modulator (SERM) postoperatively. She was lost to follow-up after discharge, and only telephone follow-up revealed a slight reduction in the left breast mass and tolerable pain. Antitumor efficacy and resectability require further evaluation. For pregnancy-associated breast cancer (PABC) complicated by severe comorbidities and multi-system involvement, individualized MDT management is crucial to ensure maternal-infant safety and improve prognosis, providing a reference for the clinical management of complex pregnancy with malignant tumors.