A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008)

Abstract

Background: Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China. Methods: According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method. Results: A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24–47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3–59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died. Conclusions: It is safe and feasible to standardize surgery and chemotherapy for PABC.

Breast Carcinogenesis during Pregnancy: Molecular Mechanisms, Maternal and Fetal Adverse Outcomes

“…According to Johansson et al [ 49 ], in a population of 317 patients with PABC, 55.5 and 12.6% of them were classified as of stage II and stage III, respectively, compared to 50.6 and 7.2% of non-PABC women with the same initial diagnosis ( p < 0.001). Similar rates were reported by a retrospective multicenter clinical study on 164 women with PABC by Jin et al, in which stage I patients accounted for 9.1%, stage II accounted for 54.9%, stage III accounted for 24.4% and stage IV accounted for 2.4% of the study population [ 50 ]. Basaran et al [ 47 ] studied a population of 20 PABC patients, 75% of whom had advanced-stage (III–IV) disease at the time of diagnosis.…”

“…Approximately 50% of women with a history of breast cancer might desire a subsequent pregnancy, with only 4–7% of them becoming pregnant. Potential explanations for this low percentage are damaged fertility due to cancer treatment and fear of a negative impact of pregnancy on the development of breast cancer, which eventually discourages the patients from trying to get pregnant [ 50 ]. Several studies have been conducted to investigate the safety of pregnancy after breast cancer diagnosis and treatment, providing reassuring data showing that pregnancy after breast cancer diagnosis and treatment does not adversely affect survival [ 75 , 76 , 77 ].…”

ystematic Review of Survival Outcomes of Pregnancy-Associated Breast Cancer in Asian Countries

“…All studies were retrospective cohort studies that reviewed medical records. Only two studies used data from a national cancer registry ( 27 , 28 ), one study had data from 27 hospitals ( 22 ) and others were single hospital data. The largest study consisted of 2,430 PABC patients from the Taiwan Cancer Registry from 2002–2014 ( 28 ).…”

“…Large, aggressive tumours ( 28 , 31 ) and advanced stage cancer ( 25 , 26 , 31 ) were more frequent in the PABC group with overexpression of human epidermal growth factor receptor 2 [HER2] ( 22 , 24 – 28 , 30 , 31 ) and oestrogen receptor negative ( 27 , 28 ) and progesterone receptor negative status ( 23 , 25 – 28 , 30 ). Seven studies documented information about surgery and treatment.…”

Promotion effect of FOXCUT as a microRNA sponge for miR-24-3p on progression in triple-negative breast cancer through the p38 MAPK signaling pathway

“…It has been shown that lncRNAs played important roles in BC progression. [20][21][22][23][24][25][26] More research has focused on the function and molecular mechanism of lncRNAs to find new targets for cancer diagnosis and therapy. In this article, we found that the expression of FOXCUT was significantly increased in TNBC tissues compared with that of normal tissues and that high expression of FOXCUT was related to poor prognosis in BC patients.…”