@article{oai:u-fukui.repo.nii.ac.jp:00028791,
 author = {加藤, 栄一 and 井上, 大輔 and 笠原, 善郎 and 久保, 真 and 伊藤, 正裕 and 前田, 浩幸 and 大田, 浩司 and 藤原, 清香 and 服部, 由香 and 坂野, 陽通 and 折坂, 誠 and 黒川, 哲司 and 吉田, 好雄 and Kato, Eichi and Inoue, Daisuke and Kasahara, Yoshiro and Kubo, Makoto and Ito, Masahiro and Maeda, Hiroyuki and Ota, kouji and Fujiwara, Sayaka and Hattori, Yuka and Banno, Harumichi and ORISAKA, Makoto and Kurokawa, Tetsuji and Yoshida, Yoshio},
 journal = {福井大学医学部研究雑誌, Journal of Interdisciplinary Research of the School of Medical Sciences, University of Fukui},
 month = {Mar},
 note = {【目的】妊娠関連乳がん（pregnancyassociatedbreastcancer;PABC）は稀な疾患だが，母児の予後に多大な影響を与えることが示唆される。しかしながら当該疾患に対する適切な診断法などの診療指針は確立されていない。本研究の目的は，本邦におけるPABCの臨床的特徴を把握，問題点を明確化し，解決すべき課題を抽出することである。
【方法】2006年から2019年に，本邦の6施設で診断・治療された妊娠関連乳がん29例において，診断時年齢，発症時期，診断契機，病期，診断までの期間，画像所見などを検討した。
【結果】29例中2例が検診で発見された。1例はマンモグラフィで，もう1例はマンモグラフィで検出できず超音波検査で発見された。29例中27例は有症状で自ら受診して発見された。主訴の内訳は，腫瘤自覚23例，血性分泌2例，張り1例，痛み1例であった。症状があるにもかかわらず10例が4か月以上も産婦人科医師に症状を相談できずにいた。また，16例は授乳期であった。乳癌の家族歴については，ありが7例，なしが17例，家族歴を聴取されていない症例が5例であった。病期は，0期２例，Ⅰ期5例，Ⅱ期13例,Ⅲ期8例，Ⅳ期1例であった。
【結論】患者はもとより，産婦人科医でさえもPABCの症状，病態を認識しておらず，乳房の生理的変化による評価の難しさから診断が遅れることがある。ほとんどの妊婦に乳癌検診が行われていないため，自己触診で腫瘤を蝕知して発見されることが多い。したがって，妊婦健診を受ける女性に対して，定期的に乳房セルフチェックを行い，変化を感じた場合には医師には報告して評価を受けるように促すべきである。PABCのリスクと病態に関する患者および臨床医の教育が今後不可欠である。


Objective: Pregnancy associated breast cancer, PABC, is a rare disease, but it can have a significant impact on the prognosis of mothers and children. However, clinical guidelines, such as appropriate diagnostic methods, have not been established. The purpose of the present study is to retrospectively analyze the clinical characteristics of PABC in Japan to clarify the current problems, and identify the issues that need to be resolved.
Methods: Twenty nine cases suffering from pregnancy associated breast cancer in Japan, which were diagnosed and treated at 6 institutions from 2006 to 2019, were evaluated using several end points, such as the age at diagnosis, the gestational, lactational or puerperal period, the disease stage at diagnosis, and category classifications of mammography and ultrasonography.
Results: Two of the 29 cases were diagnosed by screening. One of the two cases was detected by mammography and another case was detected by ultrasonography. Of the 29 cases, 27 had symptoms and were found by visiting a hospital on their own judgement. 23 had mass awareness, 2 had bloody discharge, 1 had tension, and 1 had pain. Despite having symptoms, 10 patients could not consult an obstetrician for more than 4 months by virtue of anxiousness. In addition, 16 cases were in the lactation period. There was family history of breast cancer in 7 cases, none in 17 cases, and family history was not available in 5 cases. The stages of the disease were stage 0 (2), stage I (5), stage II (13), stage III (8), and stage IV (1). Conclusion: The diagnosis of PABC is often delayed because patients and even obstetricians are not aware of the symptoms and conditions. In addition, because of the difficulty of evaluation due to physiological changes in the breast, PABC is rarely detected during medical examinations, and diagnosis is often made by palpating the mass on self-examination. This should encourage pregnant or recently pregnant women to perform regular self-breast exams and report any changes for evaluation. Education of patients and clinicians about the risks and realities of PABC will be essential in the future.},
 pages = {15--21},
 title = {本邦における妊娠関連性乳癌の臨床学的特徴の解析：多施設共同研究},
 volume = {22},
 year = {2022}
}