Prognosis of pregnancy-associated breast cancer

A meta-analysis of 30 studies

Hatem A. Azim, Luigi Santoro, William Russell-Edu, George Pentheroudakis, Nicholas Pavlidis, Fedro A. Peccatori

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Background: Pregnancy-associated breast cancer (PABC) is relatively rare with considerable controversy regarding its prognosis. Patients & methods: Two of the authors independently performed a literature search with no date or language restrictions. Eligible studies were control-matched, population-based and hospital-based studies that addressed the outcome of patients diagnosed during pregnancy or 1-year afterwards. The primary and secondary end-points were overall and disease-free survival respectively. Pooling of data was done using the random effect model. Results: 30 studies were included in this meta-analysis (3,628 cases and 37,100 controls). PABC patients had a significantly higher risk of death compared to those with non-pregnancy-related breast cancer (pooled hazard ratio (pHR): 1.44; 95% CI [1.27-1.63]). The same results were encountered on restricting the analysis to HRs of multivariate analyses (pHR: 1.40 [1.17-1.67]). A clearer trend of poorer outcome was seen in those diagnosed postpartum (pHR: 1.84; 95% CI [1.28-2.65]) than those diagnosed during pregnancy (pHR: 1.29; 95% CI [0.74-2.24]). DFS analysis showed a significantly higher risk of relapse associated with PABC as well (pHR: 1.60 [1.19-2.16]). Conclusion: Our results show that PABC is independently associated with poor survival particularly those diagnosed shortly post-partum. This underscores a possible impact of the pregnant breast microenvironment on the biology and consequently the prognosis of these tumors.

Original languageEnglish
Pages (from-to)834-842
Number of pages9
JournalCancer Treatment Reviews
Volume38
Issue number7
DOIs
Publication statusPublished - Nov 2012

Fingerprint

Meta-Analysis
Breast Neoplasms
Pregnancy
Postpartum Period
Disease-Free Survival
Breast
Language
Multivariate Analysis
Outcome Assessment (Health Care)
Recurrence
Survival
Population
Neoplasms

Keywords

  • Breast cancer during lactation
  • Pregnancy associated breast cancer
  • Prognosis
  • Relapse
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Prognosis of pregnancy-associated breast cancer : A meta-analysis of 30 studies. / Azim, Hatem A.; Santoro, Luigi; Russell-Edu, William; Pentheroudakis, George; Pavlidis, Nicholas; Peccatori, Fedro A.

In: Cancer Treatment Reviews, Vol. 38, No. 7, 11.2012, p. 834-842.

Research output: Contribution to journalArticle

Azim, Hatem A. ; Santoro, Luigi ; Russell-Edu, William ; Pentheroudakis, George ; Pavlidis, Nicholas ; Peccatori, Fedro A. / Prognosis of pregnancy-associated breast cancer : A meta-analysis of 30 studies. In: Cancer Treatment Reviews. 2012 ; Vol. 38, No. 7. pp. 834-842.
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abstract = "Background: Pregnancy-associated breast cancer (PABC) is relatively rare with considerable controversy regarding its prognosis. Patients & methods: Two of the authors independently performed a literature search with no date or language restrictions. Eligible studies were control-matched, population-based and hospital-based studies that addressed the outcome of patients diagnosed during pregnancy or 1-year afterwards. The primary and secondary end-points were overall and disease-free survival respectively. Pooling of data was done using the random effect model. Results: 30 studies were included in this meta-analysis (3,628 cases and 37,100 controls). PABC patients had a significantly higher risk of death compared to those with non-pregnancy-related breast cancer (pooled hazard ratio (pHR): 1.44; 95{\%} CI [1.27-1.63]). The same results were encountered on restricting the analysis to HRs of multivariate analyses (pHR: 1.40 [1.17-1.67]). A clearer trend of poorer outcome was seen in those diagnosed postpartum (pHR: 1.84; 95{\%} CI [1.28-2.65]) than those diagnosed during pregnancy (pHR: 1.29; 95{\%} CI [0.74-2.24]). DFS analysis showed a significantly higher risk of relapse associated with PABC as well (pHR: 1.60 [1.19-2.16]). Conclusion: Our results show that PABC is independently associated with poor survival particularly those diagnosed shortly post-partum. This underscores a possible impact of the pregnant breast microenvironment on the biology and consequently the prognosis of these tumors.",
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