Pregnancy-associated breast cancer in a contemporary cohort of newly diagnosed women.
breast cancer
pregnancy
Journal
The breast journal
ISSN: 1524-4741
Titre abrégé: Breast J
Pays: United States
ID NLM: 9505539
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
31
03
2019
revised:
28
05
2019
accepted:
26
06
2019
pubmed:
27
8
2019
medline:
22
6
2021
entrez:
27
8
2019
Statut:
ppublish
Résumé
Pregnancy-associated breast cancer (PABC) refers to breast cancer (BC) diagnosed during pregnancy, lactation, or in the postpartum period. There is evidence that PABC is associated with a poorer prognosis, and that the development of the disease is influenced by the unique hormonal milieu of pregnancy. The purpose of this study was to investigate the clinicopathologic characteristics associated with PABC in a contemporary cohort of women with newly diagnosed BC. Our institutional Breast Cancer Database was queried for women diagnosed with BC between 2009-2018 who had at least one full-term pregnancy (FTP). Variables of interest included patient demographics and clinical and tumor characteristics. PABC was defined as breast cancer diagnosed within 24 months of delivery. Statistical analyses included Pearson's chi-square and logistic regression. Out of a total of 2202 women, 46 (2.1%) had PABC. Median follow-up in the total cohort was 5.5 years. After adjusting for age at first FTP, PABC was associated with younger age at diagnosis, older age at first FTP, non-Caucasian race, BRCA positivity, presentation with a palpable mass, higher pathologic stage, higher histologic grade, and ER-negative and triple-negative receptor status. The association of PABC with non-Caucasian race may be reflected in the increased proportion of triple-negative breast cancers in the PABC group. PABC was also associated with older age at first FTP. As more women delay childbearing, risk for PABC may increase. Our findings suggest that women who become pregnant at older ages should be followed carefully during pregnancy and the postpartum period, especially if they are BRCA mutation carriers. The optimal approach for monitoring older women during pregnancy and the postpartum period is unclear.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
668-671Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Nguyen B, et al. Breast cancer diagnosed during pregnancy is associated with enrichment of non-silent mutations, mismatch repair deficiency signature and mucin mutations. NPJ Breast Cancer. 2018;4(23):1-7.
Callihan EB, Gao D, Jindal S, et al. Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer. Breast Cancer Res Treat. 2013;138(2):549-559.
Lee GE, Mayer EL, Partridge A. Prognosis of pregnancy-associated breast cancer. Breast Cancer Res Treat. 2017;163(3):417-421.
Woo JC, Yu T, Hurd TC. Breast cancer in pregnancy: a literature review. Arch Surg. 2003;138:91-99.
Andersson T-L, Johansson A, Hsieh C-C, Cnattingius S, Lambe M. Increasing incidence of pregnancy-associated breast cancer in Sweden. Obstet Gynecol. 2009;114(3):586-572.
Fedro AP, Matteo L, Giovanna S, Lino DP, Giovanni C-P. Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences. Cancer Biol Med. 2018;15(1):6-13.
Lenhard MS, Bauerfeind I, Untch M. Breast cancer and pregnancy: Challenges of chemotherapy. Crit Rev Oncolo Hematol. 2008;67(3):196-203.
Beadle BM, Woodward WA, Middleton LP, et al. The impact of pregnancy on breast cancer outcomes in women<or=35 years. Cancer. 2009;115(6):1174-1184.
Cordeiro CN, Gemignani ML. Breast cancer in pregnancy: avoiding fetal harm when maternal treatment is necessary. Breast J. 2017;23(2):200-205.
Lyons TR, Schedin PJ, Borges VF. Pregnancy and breast cancer: when they collide. J Mammary Gland Biol Neoplasia. 2009;14(2):87-98.
Azim HA Jr, Partridge A. Biology of breast cancer in young women. Breast Cancer Res. 2014;16(427):1-9.
Ruiz R, Herrero C, Strasser-Weippl K, et al. Epidemiology and pathophysiology of pregnancy-associated breast cancer: a review. Breast. 2017;35:136-141.
Viswanathan S, Ramaswamy B. Pregnancy associated breast cancer. Clin Obstet Gynecol. 2011;54(4):546-555.
Rojas KE, Bilbro N, Manasseh DM, Borgen PI. A review of pregnancy-associated breast cancer: diagnosis, local and systemic treatment, and prognosis. J Womens Health. 2018;00(00):1-7.
Schedin P, Borges V. Breaking down barriers: the importance of the stromal microenvironment in acquiring invasiveness in young women's breast cancer. Breast Cancer Res. 2009;11(2):102.
Paluch-Shimon S, Pagani O, Partridge AH, et al. Second international consensus guidelines for breast cancer in young women (BCY2). Breast. 2016;26:87-99.
Lambertini M, Di Maio M, Pagani O, et al. The BCY3/BCC 2017 survey on physicians' knowledge, attitudes and practice towards fertility and pregnancy-related issues in young breast cancer patients. Breast. 2018;42:41-49.