Pregnancy‐associated breast cancer in a contemporary cohort of newly diagnosed women

Abstract

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.

Pregnancy associated breast cancer (PABC): Report from a gestational cancer registry from a tertiary cancer care centre, India

“…The tumor-related characteristics like the grade and the receptor-status distribution (higher proportion of TNBCs) are higher compared to the other series indicating association of PABC with aggressive biology [6,27,29,30]. This could also be explained by the fact that in India breast cancer occurs a decade earlier and the TNBC and HER2-neu positivity rates are higher even in the nonpregnant women than in the west [31].…”

The Genomic Profile of Pregnancy-Associated Breast Cancer: A Systematic Review

“…Pregnancy-associated breast cancer (PABC) is generally defined as breast cancer diagnosed anytime during gestation, lactation or within 1 year after delivery ( 2 – 4 ). Several other PABC definitions with minor modifications regarding the postpartum period exist in the literature ( 2 , 5 ). Along with melanoma and cervical cancer, they are the most frequent types of pregnancy related cancer ( 3 , 6 , 7 ).…”

Clinical Features and Survival of Pregnancy-Associated Breast Cancer: A Retrospective Study of 203 Cases in China

“…Consistent with our study, Soo reported that luminal B breast cancer (43.6%) and TNBC (35.9%) predominated in PABC [8]; while one study presented a different conclusion and showed that TNBC ranked first (48.4%) [9]. Some studies did not list the molecular types but reported the HR and HER-2 status and demonstrated that PABC was more prone to be HR-negative tumors, but no difference in the HER-2 status was reported compared with non-PABC as follows: HR negative (50.0% in PABC vs. 36.1% in non-PABC, P<0.001 (Yun et al)) [10], HR negative (32.6% in PABC vs. 15.9% in non-PABC, P=0.014 (Jessica et al)) [11], and HR negative (59.4% in PABC vs. 34.4% in non-PABC, P=0.03 (Michael et al)) [12]; only one study reported by Soo showed a higher HER-2 positive rate in PABC patients as follows: HER-2 positive (38.5% in PABC vs.…”