Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: A multicenter retrospective study

Hatem A. Azim, Niels Kroman, Marianne Paesmans, Shari Gelber, Nicole Rotmensz, Lieveke Ameye, Leticia De Mattos-Arruda, Barbara Pistilli, Alvaro Pinto, Maj Britt Jensen, Octavi Cordoba, Evandro De Azambuja, Aron Goldhirsch, Martine J. Piccart, Fedro A. Peccatori

Research output: Contribution to journalArticle

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Abstract

Purpose: We questioned the impact of pregnancy on disease-free survival (DFS) in women with history of breast cancer (BC) according to estrogen receptor (ER) status. Patients and Methods: A multicenter, retrospective cohort study in which patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER, nodal status, adjuvant therapy, age, and year of diagnosis. To adjust for guaranteed time bias, each nonpregnant patient had to have a disease-free interval at least equal to the time elapsing between BC diagnosis and date of conception of the matched pregnant one. The primary objective was DFS in patients with ER-positive BC. DFS in the ER-negative cohort, whole population, and overall survival (OS) were secondary objectives. Subgroup analyses included DFS according to pregnancy outcome and BC-pregnancy interval. With a two-sided α = 5% and β = 20%, 645 ER-positive patients were required to detect a hazard ratio (HR) = 0.65. Results: A total of 333 pregnant patients and 874 matched nonpregnant patients were analyzed, of whom 686 patients had an ER-positive disease. No difference in DFS was observed between pregnant and nonpregnant patients in the ER-positive (HR = 0.91; 95% CI, 0.67 to 1.24, P = .55) or the ER-negative (HR = 0.75; 95% CI, 0.51 to 1.08, P = .12) cohorts. However, the pregnant group had better OS (HR = 0.72; 95% CI, 0.54 to 0.97, P = .03), with no interaction according to ER status (P = .11). Pregnancy outcome and BC-pregnancy interval did not seem to impact the risk of relapse. Conclusion: Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.

Original languageEnglish
Pages (from-to)73-79
Number of pages7
JournalJournal of Clinical Oncology
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 1 2013

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Estrogen Receptors
Multicenter Studies
Retrospective Studies
Breast Neoplasms
Pregnancy
Disease-Free Survival
Birth Intervals
Pregnancy Outcome
Recurrence
Survival
Cohort Studies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Prognostic impact of pregnancy after breast cancer according to estrogen receptor status : A multicenter retrospective study. / Azim, Hatem A.; Kroman, Niels; Paesmans, Marianne; Gelber, Shari; Rotmensz, Nicole; Ameye, Lieveke; De Mattos-Arruda, Leticia; Pistilli, Barbara; Pinto, Alvaro; Jensen, Maj Britt; Cordoba, Octavi; De Azambuja, Evandro; Goldhirsch, Aron; Piccart, Martine J.; Peccatori, Fedro A.

In: Journal of Clinical Oncology, Vol. 31, No. 1, 01.01.2013, p. 73-79.

Research output: Contribution to journalArticle

Azim, HA, Kroman, N, Paesmans, M, Gelber, S, Rotmensz, N, Ameye, L, De Mattos-Arruda, L, Pistilli, B, Pinto, A, Jensen, MB, Cordoba, O, De Azambuja, E, Goldhirsch, A, Piccart, MJ & Peccatori, FA 2013, 'Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: A multicenter retrospective study', Journal of Clinical Oncology, vol. 31, no. 1, pp. 73-79. https://doi.org/10.1200/JCO.2012.44.2285
Azim, Hatem A. ; Kroman, Niels ; Paesmans, Marianne ; Gelber, Shari ; Rotmensz, Nicole ; Ameye, Lieveke ; De Mattos-Arruda, Leticia ; Pistilli, Barbara ; Pinto, Alvaro ; Jensen, Maj Britt ; Cordoba, Octavi ; De Azambuja, Evandro ; Goldhirsch, Aron ; Piccart, Martine J. ; Peccatori, Fedro A. / Prognostic impact of pregnancy after breast cancer according to estrogen receptor status : A multicenter retrospective study. In: Journal of Clinical Oncology. 2013 ; Vol. 31, No. 1. pp. 73-79.
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title = "Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: A multicenter retrospective study",
abstract = "Purpose: We questioned the impact of pregnancy on disease-free survival (DFS) in women with history of breast cancer (BC) according to estrogen receptor (ER) status. Patients and Methods: A multicenter, retrospective cohort study in which patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER, nodal status, adjuvant therapy, age, and year of diagnosis. To adjust for guaranteed time bias, each nonpregnant patient had to have a disease-free interval at least equal to the time elapsing between BC diagnosis and date of conception of the matched pregnant one. The primary objective was DFS in patients with ER-positive BC. DFS in the ER-negative cohort, whole population, and overall survival (OS) were secondary objectives. Subgroup analyses included DFS according to pregnancy outcome and BC-pregnancy interval. With a two-sided α = 5{\%} and β = 20{\%}, 645 ER-positive patients were required to detect a hazard ratio (HR) = 0.65. Results: A total of 333 pregnant patients and 874 matched nonpregnant patients were analyzed, of whom 686 patients had an ER-positive disease. No difference in DFS was observed between pregnant and nonpregnant patients in the ER-positive (HR = 0.91; 95{\%} CI, 0.67 to 1.24, P = .55) or the ER-negative (HR = 0.75; 95{\%} CI, 0.51 to 1.08, P = .12) cohorts. However, the pregnant group had better OS (HR = 0.72; 95{\%} CI, 0.54 to 0.97, P = .03), with no interaction according to ER status (P = .11). Pregnancy outcome and BC-pregnancy interval did not seem to impact the risk of relapse. Conclusion: Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.",
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AU - Azim, Hatem A.

AU - Kroman, Niels

AU - Paesmans, Marianne

AU - Gelber, Shari

AU - Rotmensz, Nicole

AU - Ameye, Lieveke

AU - De Mattos-Arruda, Leticia

AU - Pistilli, Barbara

AU - Pinto, Alvaro

AU - Jensen, Maj Britt

AU - Cordoba, Octavi

AU - De Azambuja, Evandro

AU - Goldhirsch, Aron

AU - Piccart, Martine J.

AU - Peccatori, Fedro A.

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N2 - Purpose: We questioned the impact of pregnancy on disease-free survival (DFS) in women with history of breast cancer (BC) according to estrogen receptor (ER) status. Patients and Methods: A multicenter, retrospective cohort study in which patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER, nodal status, adjuvant therapy, age, and year of diagnosis. To adjust for guaranteed time bias, each nonpregnant patient had to have a disease-free interval at least equal to the time elapsing between BC diagnosis and date of conception of the matched pregnant one. The primary objective was DFS in patients with ER-positive BC. DFS in the ER-negative cohort, whole population, and overall survival (OS) were secondary objectives. Subgroup analyses included DFS according to pregnancy outcome and BC-pregnancy interval. With a two-sided α = 5% and β = 20%, 645 ER-positive patients were required to detect a hazard ratio (HR) = 0.65. Results: A total of 333 pregnant patients and 874 matched nonpregnant patients were analyzed, of whom 686 patients had an ER-positive disease. No difference in DFS was observed between pregnant and nonpregnant patients in the ER-positive (HR = 0.91; 95% CI, 0.67 to 1.24, P = .55) or the ER-negative (HR = 0.75; 95% CI, 0.51 to 1.08, P = .12) cohorts. However, the pregnant group had better OS (HR = 0.72; 95% CI, 0.54 to 0.97, P = .03), with no interaction according to ER status (P = .11). Pregnancy outcome and BC-pregnancy interval did not seem to impact the risk of relapse. Conclusion: Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.

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