Impact of pregnancy on non-metastatic breast cancer: A case control study

Ezzat, Adnan; Raja, M. A.; Berry, John; Zwaan, F.; Jamshed, Arif; Rhydderch, D.; Rostom, A.Y.; Bazarbashi, Shouki

doi:10.1016/s0936-6555(96)80081-1

Cited by 48 publications

(23 citation statements)

References 21 publications

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“…Historically pregnancy-associated breast cancer was thought to be rapid in course, excessively malignant, and incurable [12,13]. More recently, the prognosis of gestational breast cancer has been shown to be similar to that of nonpregnant women when age and stage at presentation are accounted for (Table 1) [4,14,15]. Notably, both Anderson and colleagues [16] and Ishida and colleagues [9] document no difference in the prognosis of early cancers (when matched for age and stage), but a poorer prognosis is demonstrated for patients with more advanced disease.…”

Section: Prognosismentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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Breast cancer, along with cervical cancer, is one of the most commonly diagnosed cancers of pregnancy. Most would define gestational breast cancer as breast cancer that is diagnosed during pregnancy, lactation, and up to 12 months post-partum. The diagnostic and therapeutic implications in this clinical setting are special. These women typically present with a more advanced-stage disease that carries an associated poorer prognosis. Physicians thus are challenged to balance aggressive maternal care with appropriate modifications that will ensure fetal protection. . Of women diagnosed with breast cancer younger than 40 years, only approximately 10% will be pregnant [2,3]. These data certainly suggest a low incidence of pregnancy-associated breast cancer. In fact, historically, the incidence is estimated at 1 in 3000 pregnancies [4][5][6]. Despite the overall low incidence, however, gestational breast cancer is one of the most common pregnancy-associated malignancies, second only to cervical cancer [4,6]. Notably, many have offered that this incidence will only increase as more women delay childbearing until later in life [4,7]. This concern is based on the fact that pregnancy-associated breast cancer is age-related, and women

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Section: Prognosismentioning

confidence: 99%

Pregnancy-Associated Breast Cancer: A Literature Review

Barnes

Newman

2007

Surgical Clinics of North America

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“…The role of pregnancy in the prognosis of breast cancer remains controversial. Many studies did not suggest any significant associations [7,8,9,10,11,12,13], whereas others attributed any detrimental effects solely on the delayed diagnosis of tumors in pregnancy [14,15,16,17,18]. On the contrary, some studies pointed to the opposite direction, indicating an independent poor prognostic role of pregnancy [19,20,21].…”

Section: Introductionmentioning

confidence: 99%

Does Pregnancy-Associated Breast Cancer Imply a Worse Prognosis? A Matched Case-Case Study

et al. 2013

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Background: Significant controversy exists in the literature regarding the role of pregnancy in the prognosis of breast cancer. We designed a matched case-case study, matching pregnancy-associated breast cancer (PABC) cases with breast cancer cases for stage, age, and year of diagnosis. Patients and Methods: 39 consecutive cases of PABC were matched with 39 premenopausal cases of breast cancer. Univariate and multivariate survival analyses followed by adjustment for stage, grade, estrogen receptor status, and age at diagnosis, were performed. Results: Regarding overall survival (OS), univariate analysis pointed to longer OS in non-PABC cases vs. PABC cases. Accordingly, a more advanced stage predicted shorter survival. In the multivariate analysis, the independent aggravating effect mediated by pregnancy persisted. Interestingly, a post hoc nested analysis within PABC cases indicated that the 3rd trimester pointed to shorter OS. The aforementioned results on OS were also replicated during the examination of relapse-free survival. Conclusion: Implementing a matched case-case design, the present study points to pregnancy as a poor prognostic factor for breast cancer.

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“…Previous reports have suggested that PABC tends to be more advanced than non-PABC 4–6. Furthermore, some studies have suggested that the relatively poor outcome of these patients may be because of this aspect of their disease, rather than the pregnancy itself, and that pregnant patients may not have a worse prognosis when age and stage are taken into account 7,8. However, all of these studies have been hindered by relatively small sample sizes, heterogeneous treatment techniques that have evolved over time, and limited controls.…”

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confidence: 99%

The impact of pregnancy on breast cancer outcomes in women ≤35 years

Beadle

Woodward

Middleton

et al. 2009

Cancer

156

109

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BACKGROUND:Some evidence suggests that women with pregnancy‐associated breast cancers (PABC) have a worse outcome compared with historical controls. However, young age is a worse prognostic factor independently, and women with PABC tend to be young. The purpose of the current study was to compare locoregional recurrence (LRR), distant metastases (DM), and overall survival (OS) in young patients with PABC and non‐PABC.METHODS:Data for 668 breast cancers in 652 patients aged ≤35 years were retrospectively reviewed. One hundred four breast cancers (15.6%) were pregnancy‐associated; 51 cancers developed during pregnancy and 53 within 1 year after pregnancy.RESULTS:The median follow‐up for all living patients was 114 months. Patients who developed PABC had more advanced T classification, N classification, and stage group (all P < .04) compared with patients with non‐PABC. Patients with PABC had no statistically significant differences in 10‐year rates of LRR (23.4% vs 19.2%; P = .47), DM (45.1% vs 38.9%; P = .40), or OS (64.6% vs 64.8%; P = .60) compared with patients with non‐PABC. For those patients who developed breast cancer during pregnancy, any treatment intervention during pregnancy provided a trend toward improved OS compared with delaying evaluation and treatment until after delivery (78.7% vs 44.7%; P = .068).CONCLUSIONS:Young patients with PABC had no statistically significant differences in LRR, DM, or OS compared with those with non‐PABC; however, pregnancy contributed to a delay in breast cancer diagnosis, evaluation, and treatment. Primary care and reproductive physicians should be aggressive in the workup of breast symptoms in the pregnant population to expedite diagnosis and allow multidisciplinary treatment. Cancer 2009. © 2009 American Cancer Society.

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Impact of pregnancy on non-metastatic breast cancer: A case control study

Cited by 48 publications

References 21 publications

Pregnancy-Associated Breast Cancer: A Literature Review

Pregnancy-Associated Breast Cancer: A Literature Review

Does Pregnancy-Associated Breast Cancer Imply a Worse Prognosis? A Matched Case-Case Study

The impact of pregnancy on breast cancer outcomes in women ≤35 years

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