Prognosis of breast cancer diagnosed during pregnancy and early postpartum according to immunohistochemical subtype: A matched case-control study.

Autor: Muñoz-Montaño WR; Breast Medical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Cabrera-Galeana P; Breast Medical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., De la Garza-Ramos C; Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, Real San Agustin, San Pedro Garza Garcia, NL, Mexico., Azim HA Jr; Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, Real San Agustin, San Pedro Garza Garcia, NL, Mexico., Tabares A; Breast Medical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Perez V; Oncological Pathology of Mammary Tumors Unit, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Porras Reyes F; Oncological Pathology of Mammary Tumors Unit, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Sanchez Benitez D; Medical School, National Autonomous University of Mexico, Mexico City, Mexico., Alvarado-Miranda A; Breast Medical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Lara-Medina F; Breast Medical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Vazquez Romo R; Breast Surgical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Bargallo-Rocha E; Breast Surgical Oncology, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico., Arrieta O; Research Unit, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico. ogar@unam.mx.; Head of Thoracic Oncology Unit and Laboratory of Personalized Medicine, National Institute of Cancer, San Fernando #22, Section XVI, 14080, Tlalpan, Mexico City, Mexico. ogar@unam.mx., Villarreal-Garza C; Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, Real San Agustin, San Pedro Garza Garcia, NL, Mexico. cynthiavg@gmail.com.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2021 Jul; Vol. 188 (2), pp. 489-500. Date of Electronic Publication: 2021 Jun 16.
DOI: 10.1007/s10549-021-06225-4
Abstrakt: Purpose: Pregnancy-associated breast cancer (PABC) poses a clinical challenge and its prognosis remains controversial. During the pregnancy and postpartum periods, the breast undergoes biological events that may uniquely influence disease behavior and treatment response. This study aimed to assess if a PABC diagnosis influences survival compared to non-PABC.
Methods: A single-center record review was performed to identify PABC patients diagnosed from January 2007 through June 2018. Two controls were matched to each PABC case by stage, immunohistochemical (IHC) subtype, age (± 3) and year of diagnosis (± 2). Disease-free survival (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with the log-rank test. Multivariate analysis was used to assess the impact of PABC on outcomes.
Results: 125 PABC patients (pregnant: 62; postpartum: 63) and 250 controls were included. Median follow-up was 67.7 and 73.4 months, respectively. 4-year DFS was 62% in pregnant vs 78% in controls (p = 0.010), and 63% in postpartum vs 83% in controls (p = 0.034). Subanalysis by IHC subtype revealed a significantly inferior DFS in PABC with hormone receptor-positive/HER2-negative (p = 0.032) and HER2-positive disease (p = 0.005) compared to corresponding non-PABC patients. 4-year OS was similar between case groups and controls. Multivariate analysis supported the independent impact of pregnant and postpartum status on DFS (p < 0.05).
Conclusion: Patients diagnosed during pregnancy and early postpartum are at high risk of recurrence. Further research is warranted to better characterize PABC tumor biology and enable the identification of novel therapeutic interventions to improve treatment outcomes.
Databáze: MEDLINE
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