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懷孕時確診乳腺癌，真的只能終止妊娠嗎？真相或和你想象的不一樣

出處：@熊貓醫(yī)學官方號 日期：2024-07-27 13:22:52 編輯：網(wǎng)絡收集

關于乳腺癌，相信大家都不陌生，但就妊娠期乳腺癌來說，很多人對它的了解卻并不深刻，當然，妊娠期乳腺癌也并不難理解，這一疾病其實就是指女性在妊娠期間或產(chǎn)后一年被診斷出來的乳腺癌，在臨床上，妊娠期乳腺癌的發(fā)病率其實并不高，但即便如此，大家對這一疾病也要有所了解，并且正確對待。

通常情況下，患者在妊娠期發(fā)現(xiàn)乳腺癌時，先思考的是肚子里的孩子是否還能孕育下去，對于這一問題，醫(yī)學給出的建議是，絕大多數(shù)妊娠期乳腺癌患者都沒有必要放棄腹中的胎兒，因為即便終止妊娠，也并不會改變當下患上乳腺癌的事實。

相較于一味糾結(jié)是否終止妊娠，患者更需要考慮的其實是以下幾方面因素：首先，是否愿意承擔妊娠期間因治療乳腺癌所帶來的可能存在的毒性以及并發(fā)風險；

其次，自己的預后以及照顧子女的能力是否有限；治療乳腺癌是否會對自己將來的生育能力產(chǎn)生影響等等。

一般情況下，臨床會建議處于孕早期就發(fā)現(xiàn)了III或IV期乳腺癌，并且疾病進展迅速，預計在生存期內(nèi)無法完成妊娠等情況下的患者考慮終止妊娠。

那么，對于妊娠期乳腺癌患者來說，哪些檢查能做，哪些不建議做呢？除了乳頭溢液型等特殊癥狀的乳腺癌之外，可以通過對腫物進行核心穿刺，或者是真空輔助旋切活檢術來進行進一步的診斷，而且這些檢查手段能夠在妊娠期的任何一個階段進行，而乳腺癌的診斷除了明確有無惡性腫瘤之外，還需要對其他方面的檢查進行進一步完善，以具體當下正處于癌癥的哪一階段，然后才能展開分期的具體治療。

而其中肝臟超聲檢查大多不會對胎兒造成影響，胎兒處于15周以上，且對腹部進行了相應防護的情況下，胸片、CT掃描檢查通常也不會對胎兒造成太大的輻射劑量，是相對安全，能夠考慮進行的一項檢查。但對于乳腺磁共振以及CT增強等檢查項目來說，在當下則不建議立即進行。

可能很多人還會有這樣一個疑問，那就是妊娠期乳腺癌確診后，是否還能繼續(xù)保留乳房？對此，在這里也給大家進行相關的科普。

對于妊娠期大于12周才得以確診的乳腺癌患者來說，其手術適應癥與普通類型的乳腺癌并沒有太大差別，但有兩個點是大家需要注意的，一方面是腋窩前哨淋巴結(jié)活檢的爭議：就美蘭染色來說，它并不能用在患有妊娠期乳腺癌的患者身上，而就同位素示蹤法的使用而言，關于其是否存在輻射，目前也具有一定爭議，因此，關于腋窩淋巴結(jié)的清掃，當下仍然屬于標準手術方案；

另一方面就是處于妊娠期時沒有辦法進行化療，對于妊娠早期乳腺腫瘤患者來說，即便處于一、二期階段，也需要進行乳房切除術，而對于妊娠中晚期患者來說，則可以考慮乳腺癌保乳術，但要注意的是，手術與放療之間的時間間隔不能超過六個月。

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