Prognosis no poorer in pregnancy-associated breast cancer
MedWire News: Women with pregnancy-associated breast cancer (PABC) have a similar prognosis to those with non-gestational cancer, despite the challenges associated with cancer treatment during pregnancy, researchers report.
To establish the epidemiology, management, and outcome of women with PABC, Halsaka and team studied 32 women aged 26 to 41 years, 16 of whom were diagnosed with PABC during pregnancy and 16 who were diagnosed with PABC within 1 year of delivery.
They compared data concerning diagnosis, management, delivery, and fetal and maternal outcome with data from a group of 32 women with non-PABC, matched for age at diagnosis, tumor size, and tumor stage.
The researchers report that histologic tumor features were similar in both groups, with the only difference significantly more estrogen receptor-negative tumors in the PABC group compared with the non-PABC group.
Gestational age was the most important factor in determining the selected treatment procedure. Three patients received chemotherapy and two others underwent surgery during pregnancy, with no excess toxicity or severe maternal/fetal adverse effects.
After completion of pregnancy, all patients subsequently received full-dose combination chemotherapy, and all but one patient underwent surgery.
Of note, all children in the PABC group were healthy, except for one exposed to epirubicin in utero and born with rectal atresia.
Overall survival was similar in PABC and non-PABC patients, with 10 deaths occurring among the PABC patients and nine deaths occurring among the non-PABC patients during a median follow up of 2.75 and 4.10 years, respectively.
However, the subgroup of patients with breast cancer diagnosed within 1 year of delivery showed a significantly shorter time to relapse than controls or patients with gestational cancer.
“This finding, if confirmed in subsequent work in a larger series, could reflect persistence of diagnostic delays, distinct tumor biology, host immune dysfunction, or an aberrant hormonal milieu,” conclude Halsaka and co-authors in the Breast Journal.
They add that data registration is needed to expand clinical experience and lead to a better understanding of tumor and host biology in gestational cancer.
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By Laura Dean