Open AccessSurvival Outcomes in Pregnancy Associated Breast Cancer: A Retrospective Case Control Study
Author(s) -
Ali Sheikh Asim,
Gupta Sameer,
Sehgal Rajesh,
Vogel Victor
Publication year - 2012
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/j.1524-4741.2011.01201.x
Subject(s) - medicine , breast cancer , pregnancy , retrospective cohort study , univariate analysis , gynecology , stage (stratigraphy) , oncology , obstetrics , cancer , multivariate analysis , paleontology , genetics , biology
Pregnancy‐associated breast cancer (PABC) has been defined as breast cancer diagnosed during pregnancy or within one year of delivery. It is believed that after adjusting for age and stage, the 5‐year survival rates are the same in both pregnant and nonpregnant women. We conducted a retrospective case‐control study among patients treated at our institution between 1990 and 2005 to compare the 5‐year survival outcomes for PABC with women treated for breast cancer who were not pregnant. Overall survival (OS) and disease‐free survival (DFS) were estimated by the Kaplan–Meier method, and log rank tests were used to assess the associations between OS, DFS and pregnancy status, HER‐2 status, ER/PR status, and family history. The median age was 33 years (range 24–42) for both groups. Twenty‐two (55%) patients with PABC were ER/PR receptor positive compared with 20 (50%) for the controls. Ninety percent of patients with PABC received chemotherapy compared with 87.5% in the nonpregnant group. 91.5% of patients with PABC had breast‐conserving surgery and 8.5% had mastectomies compared with 86% and 14%, respectively, for the control group. The median OS was 4.9 years in the PABC group compared with 6 years for the controls (p = 0.02). The median DFS was 2.7 years for the PABC group compared with 5.1 years for the controls (p = 0.01). The most common site of relapse was bone for the PABC group (27%) and local recurrence (33%) for the controls. Univariate analysis revealed that OS and DFS were associated with pregnancy status, family history, ER/PR status, and stage. After adjusting for age and stage, PABC patients had higher risk of both death (p = 0.01) and recurrence (p = 0.02) compared with nonpregnant controls. Women with PABC had significantly shorter OS and DFS compared with nonpregnant age and stage‐matched controls.