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Evidence of poorer survival in pregnancy-associated breast cancer
Obstetrics and Gynecology, 07/03/08

Rodriguez AO et al. - In a trial to compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non–pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer, it was shown that pregnancy-associated breast cancer presented with more advanced disease, larger tumors, and increased percentage of hormone receptor–negative tumors. When controlled for stage, race, and hormone receptor status, these cases had a slightly higher risk of death, even when only localized-stage disease was considered

• Women with breast cancer occurring within 9 months before or 1 year after an obstetric delivery were identified
• Age-matched, non–pregnancy-associated breast cancer controls were also identified
• Demographics, cancer stage, tumor size, histology, hormone receptor status, type of treatment, and survival were reviewed and compared
• Predictive factors for death from breast cancer were identified using proportional hazards modeling

• 797 pregnancy-associated breast cancer cases were compared with 4177 non–pregnancy-associated breast cancer controls
• Pregnancy-associated breast cancer cases were significantly more likely to have more advanced stage, larger primary tumor, hormone receptor negative tumor, and mastectomy as a component of their treatment
• In survival analysis, pregnancy-associated breast cancer had a higher death rate than non–pregnancy-associated breast cancer (39.2% vs 33.4%)
• Advancing stage, race, hormone receptor–negative tumors, and pregnancy were all significant predictors of death

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