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

Abstract

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.

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

“…As far as outcome of PABC is concerned data are conflicting: some authors showed no difference in outcome of PABC and non-PABC cases [14,16,24], while others consider PABC as having unfavorable prognosis [1,[7][8][9]. In a recent metaanalysis of 30 studies, Azim et al found that PABC patients had poor overall survival especially if breast cancer was diagnosed within 1 year postpartum [25].…”

Prognosis of breast cancer during pregnancy: evidence for nursing care

“…On the other hand, in two studies included in the integrative review, the results did not show statistically significant difference concerning survival rate in a comparison between PABC women and the control group (nonpregnant women) (17)(18) .…”

“…Beadle et al (18) To compare the rates of locoregional recurrence, metastases and survival in young patients (35 years old or younger) who developed PABC to non-PABC women.…”

“…These results are corroborated by two other studies (32)(33) . Two studies in the review indicate a poor prognosis for breast cancer (18,21) .…”

Breast Cancer in Women under 30 is Highly Aggressive with Extremely Low Frequency: a Case Report

“…Likewise, the desire of these women to be pregnant may delay the diagnosis, many breast cancers becoming clinically evident during gestation or immediately after delivery [18][19][20]. Hence, breast palpation, ultrasonography of breasts and armpits, and biopsy of the tumor tissue (punch biopsy) are considered to be the gold standard in the evaluation of masses occurring in a woman under 30 [14].…”