Perinatal outcomes of women with gestational breast cancer in Australia and New Zealand: A prospective population-based study.

Autor: Sullivan E; College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia., Safi N; College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia., Li Z; College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia., Remond M; College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia., Chen TYT; Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia., Javid N; Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia., Dickinson JE; Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia., Ives A; Faculty of Health and Medical Sciences, Medical School, The University of Western Australia, Perth, Western Australia, Australia., Hammarberg K; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Anazodo A; School of Women and Children, University of New South Wales, Sydney, New South Wales, Australia., Boyle F; Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital Sydney, and University of Sydney, Sydney, New South Wales, Australia., Fisher J; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Halliday L; School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia., Duncombe G; Faculty of Medicine, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia., McLintock C; National Women's Health, Auckland City Hospital, Auckland, New Zealand., Wang AY; Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia., Saunders C; Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Birth (Berkeley, Calif.) [Birth] 2022 Dec; Vol. 49 (4), pp. 763-773. Date of Electronic Publication: 2022 Apr 26.
DOI: 10.1111/birt.12642
Abstrakt: Objective: To determine the epidemiology, clinical management, and outcomes of women with gestational breast cancer (GBC).
Methods: A population-based prospective cohort study was conducted in Australia and New Zealand between 2013 and 2014 using the Australasian Maternity Outcomes Surveillance System (AMOSS). Women who gave birth with a primary diagnosis of breast cancer during pregnancy were included. Data were collected on demographic and pregnancy factors, GBC diagnosis, obstetric and cancer management, and perinatal outcomes. The main outcome measures were preterm birth, maternal complications, breastfeeding, and death.
Results: Forty women with GBC (incidence 7.5/100 000 women giving birth) gave birth to 40 live-born babies. Thirty-three (82.5%) women had breast symptoms at diagnosis. Of 27 women diagnosed before 30 weeks' gestation, 85% had breast surgery and 67% had systemic therapy during pregnancy. In contrast, all 13 women diagnosed from 30 weeks had their cancer management delayed until postdelivery. There were 17 preterm deliveries; 15 were planned. Postpartum complications included the following: hemorrhage (n = 4), laparotomy (n = 1), and thrombocytopenia (n = 1). There was one late maternal death. Eighteen (45.0%) women initiated breastfeeding, including 12 of 23 women who had antenatal breast surgery. There were no perinatal deaths or congenital malformations, but 42.5% of babies were preterm, and 32.5% were admitted for higher-level neonatal care.
Conclusions: Gestational breast cancer diagnosed before 30 weeks' gestation was associated with surgical and systemic cancer care during pregnancy and planned preterm birth. In contrast, cancer treatment was deferred to postdelivery for women diagnosed from 30 weeks, reflecting the complexity of managing expectant mothers with GBC in multidisciplinary care settings.
(© 2022 The Authors. Birth published by Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: