Clinical features and survival of pregnancy-associated breast cancer: a retrospective study of 203 cases in China

Abstract

Background: Pregnancy-associated breast cancer (PABC) is an aggressive disease, and since Chinese authority began to encourage childbearing in 2015, the incidence of PABC has increased. This study investigated the characteristics and survival of PABC patients. Methods: Patients with PABC who underwent surgery at Fudan University, Shanghai Cancer Center between 2005 and 2018 were enrolled. Data concerning the tumor characteristics, maternal state (whether first or nonfirst pregnancy) and survival outcome were recorded. Pearson Chi-square tests were used to compare the characteristics of the tumors, and Kaplan-Meier methods were used to perform the survival analysis. Results: Overall, 203 PABC patients were recruited. Since 2015, 65.5% of non-first pregnant women were diagnosed with breast cancer, it's 5.7 fold of the incidence of PABC in non-first pregnant women. No significant differences in tumor characteristics were observed between the patients who were in their first pregnancy and those in non-first pregnancy. Among the entire PABC population, luminal B breast cancer accounted for the largest proportion (38.4%), followed by triple-negative breast cancer (TNBC, 30.0%). The distribution of the molecular subtypes of PABC and non-PABC differed (P < 0.001) as follows: in the PABC patients, Luminal B 38.4%, Triple negative breast cancer (TNBC) 30.1%, Human Epidermal Growth Factor Receptor 2 (HER-2) overexpression 15.8%, and Luminal A 10.8%; in the non-PABC patients, Luminal A 50.9%, Luminal B 20.1%, TNBC 17.4%, and HER-2 overexpression 8.0%. The 3-year disease free survival (DFS) of all PABC patients was 80.3%. The 3-year DFS of the patients in the first-pregnancy group was 78.4%, and that of the patients in the non-first-pregnancy group was 83.7% (P = 0.325). Conclusions: Our study proved that the proportion of women who developed PABC during the second or third pregnancy was extremely high relative to the newborn populations. The patients in the PABC population tended to present more luminal B and TNBC breast cancer than the non-PABC patients.

Breast Cancer During Pregnancy: A Marked Propensity to Triple-Negative Phenotype

“…A study by Harvell et al analyzed the presence of breast cancer subtypes in PABC and found that the presence of Luminal A, Luminal B, Her2-positive, TNBC, and basal-like subtypes in PABC ( 58 ). Other studies also confirmed TNBC, Luminal B and HER2-positive as the most common subtypes among PABC while luminal A subtype was rare ( 25 , 52 , 59 – 61 ) ( Table 1 ).…”

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

“…The 11 included studies were from six countries: China (4), South Korea (2), Taiwan (2), Japan (1), India (1) and Saudi Arabia (1). Four studies did not mention whether the PABC patients were diagnosed antepartum or postpartum ( 24 , 26 , 27 , 29 ).…”

Pregnancy associated breast cancer: Correlation between Parity and Prognostic Factors

“…A retrospective study of PABC patients treated in our hospital from 2005 to 2018 suggested that the incidence of PABC in non-rst-pregnancies was higher than that in rst-pregnancies [7]. However, the correlation between parity and prognosis of breast cancer was unclear.…”

“…Previous studies have reported that the prognosis of PABC is worse than that of non-PABC [3][4][5][6], but no comparison has been studied regarding parity. A recent retrospective study in our center showed higher incidence of PABC in non-rst-pregnant women than in rst-pregnant women [7]. In this study, we retrospectively analyzed the clinical and pathological characteristics of PABC, and preliminarily explored the correlation between parity and the prognostic factors of breast cancer.…”