Pregnancy-associated breast cancers: Do they differ from other breast cancers in young women?

Abstract

The impact of pregnancy in the physiopathology of pregnancy-associated breast cancer (PABC) is still unclear. We compared the characteristics of PABCs and breast cancers not associated with pregnancy (non-PABCs) in terms of their loco-regional invasion and histological phenotype. We conducted a retrospective chart review on women less than 43 years of age treated for breast cancer from January 1, 2004 to December 31, 2010. We compared age at diagnosis, loco-regional invasion and histological data. We recorded 282 breast cancers in 276 patients. Forty-one tumors (14.5%) were PABCs. PABC patients were significantly younger than non-PABC patients. Compared with the non-PABCs, PABCs were twice more frequent advanced tumors (T3-4) and have twice more frequent HER2 over-expression and hormone negative status. The more aggressive histological profile observed in the PABCs, especially in post-partum tumors and women older than 35 years of age, seems to be a direct consequence of the association with pregnancy.

Clinicopathological Features and Prognosis of Pregnancy Associated Breast Cancer – A Matched Case Control Study

“…The majority supply information on the invasive tumor's type, grade and TNM stage, together with only the immunohistochemistry (IHC) assessment of hormonal receptors (with incomplete data provided by most of the studies); data on Her2 status [12][13][14][15][16][17][18][19], Ki67 labeling index [12,15,17], p53 [12,18], IHC-based tumor subtype [15] as well as on the characteristics of eventual associated in situ lesions [19] are scarce. To the best of our knowledge this is the first matched case control study that combines information on the management and outcome of PABC patients together with analysis of all the relevant histopathology and IHC information the pathologist can provide on the multidisciplinary approach to PABC.…”

Current management of pregnancy-associated breast cancer

“…Nonetheless, studies have found that pregnancy increases the risk of breast cancer initially following delivery and has a protective effect after a period of time. 3 The period of increased risk has been estimated to be between 10 and 15 years following a first pregnancy. The later the first pregnancy, the longer the duration of increased risk before the protective effect.…”

“…2,5,9 They also have a lower incidence of positive hormone receptor status. 3 Placental metastasis is rare but indicates poor maternal prognosis. Pathological assessment after delivery is recommended in all cases.…”

“…1 It is the most common malignancy associated with pregnancy and the incidence is expected to rise in high-income countries. [2][3][4] Historically, this disease entity was thought to have a worse prognosis when compared with patients diagnosed with cancer in the non-pregnant state and termination of pregnancy was common. Here, we reviewed recent publications and summarised the most recent information.…”

Pregnancy-associated breast cancer and pregnancy following treatment for breast cancer, in a cohort of women from Victoria, Australia, with a first diagnosis of invasive breast cancer

“…16 Some studies have only included women under 35 years, 7,17 43 years 7 or 45 years. 18 Our study included women aged up to 48 years, as did the study by Murphy et al 19 Although the proportion of women with PABC diagnosed under the age of 35 years appears to be consistent across studies, 7,17 as women are tending to have children later, the contribution of PABC to BC amongst younger women may decline. In Australia, the peak birth rate shifted from women aged 25e29 years in 1999, to women aged 30e34 years in the year 2000.…”