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2013, Number 2

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Cir Cir 2013; 81 (2)

Pregnancy and breast cancer

Ramírez-Torres N, Asbun-Bojalil J, Hernández-Valencia M

Language: Spanish
References: 46
Page: 98-107
PDF size: 1053.43 Kb.


ABSTRACT

Introduction: association of breast cancer and pregnancy is not common. The objective of this investigation was to evaluate the pregnancy, young age, stage, treatment, prognosis and mortality of women with breast cancer during pregnancy.
Methods: retrospective analysis from March 1992 to February 2009, 16 patients were included with breast cancer and pregnancy. They were analized: histological characteristic of tumor, therapeutic response of the oncological treatment, evolution of the pregnancy. From of baby born: Apgar and weight. The woman’s mortality with breast cancer during pregnancy was evaluated for age group and for interval of time between late pregnancy and diagnosis posterior of breast cancer and pregnancy.
Results: characteristic predominant clinicohistological: stage III (81.2%), T3-T4 (75%), N+ 93.7%, invasive ductal carcinoma (87.5%), histological grade 2-3 (93.7%), receptor estrogeno positive (43.7%); RP positive (25%); HER-2/neu positive (31.2%). 27 chemotherapy cycles were applied with 5-fluorouracil, epirubicin and cyclophosphamide during the second or third trimester of the pregnancy, there were not severe adverse effects for the mothers and the baby born exposed to chemotherapy. The mean time to disease recurrence was 18.8 months (range, 6-62 months). The rate of mortality for specific age (‹ 35 years) was of 31.3% (p = 0.358). From the 16 patients, 7 have died and 9 were live without evidence of disease.
Conclusions: the advanced stage and the number of affected axillary lymph node more than the age was predictors of worse pronostic influencing the relapse and mortality of the young patients with breast cancer and pregnancy.


REFERENCES

  1. Ferlay J, Bray F, Pisani P. Globocan 2002: Cancer incidence, mortality and prevalence worwilde. Lyon: IARC Press;2004.

  2. Wallack MK, Wolf JA Jr, Bedwinek J, Denes AE, Glasgow G, Kumar B, et al. Gestational carcinoma of the female breast. Curr Probl Cancer 1983;7(9):1-58.

  3. Loibl S, von Minckwitz G, Gwyn K, Ellis P, Blohmer JU, Schlegelberger B, et al. Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer 2006;106(2):237-246.

  4. Andersson TML, Johansson ALV, Hsieh CC, Cnattingius S, Lambe M. Increasing incidence of Pregnancy-Associated Breast Cancer in Sweden. Obstet Gynecol 2009;114(3):568-572.

  5. Centers for Disease Control and Prevention. (consultado Agosto 2012). disonible en: [http://www.cdc.gov/nchs/products/vsus. htm]. Vital Statistics of the United States, 2002. Vol. I. Natality. Hyattsville, MD: National Center for Health Statistics; 2007.

  6. Stensheim H, Moller B, van Dijk T, Fossa SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009;27(1):45-51.

  7. de la Rochefordiere A, Campana F, Fenton J, Vilcoq JR, Fourquet A, Asselain B, et al. Age as prognostic factor in premenopausal breast carcinoma. Lancet 1993;341(8852):1039-1043.

  8. Anderson BO, Petrek JA, Byrd DR, Senie RT, Borgen PI. Pregnancy influences breast cancer stage at diagnosis in women 30 years of age and younger. Ann Surg Oncol 1996;3(2):204-211.

  9. Beadle BM, Woodward WA, Middleton LP, Tereffe W, Strom EA, Litton JK, et al. The impact of pregnancy on breast cancer outcomes in women < 35 years. Cancer 2009;115(6):1174-1184.

  10. Middleton LP, Amin M, Gwym K, Theriault R, Sahin A. Breast carcinoma in pregnant women. Assessment of clinicopathologic and inmunohistochemical features. Cancer 2003;98(5):1055-1060.

  11. Petrek JA, Dukoff R, Rogatko A. Prognosis of pregnancy-associated breast cancer. Cancer 1991;67(4):869-872.

  12. Romero JR, Hernández EF, Nava HMC. Carcinoma mamario y embarazo. Rev Mex Mastol 1992;1:7-17.

  13. León Villalba JC, López Graniel CM, Lara Medina F, Calderón GEd, Chanona-Vilchis G, Solorza Luna G. Cáncer y embarazo. Experiencia en el Instituto de Cancerología de México. Rev Inst Nal Cancerol Mex 1999;45(3):144-152.

  14. Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 1996;78(8):1838-1843.

  15. Bleyer A. Young Adult Oncology: The Patients and Their Survival Challenges. CA Cancer J Clin 2007;57(4):242-255.

  16. Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 2003;189(4):1128-1135.

  17. Antonelli NM, Dotters DJ, Katz VL, Kuller JA. Cancer in Pregnancy: A Review of the Literature. Part I. Obstet Gynecol Surv 1996;51(2):125-134.

  18. Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, et al. Young Age at Diagnosis Correlates With Worse Prognosis and Defines a Subset of Breast Cancers With Shared Patterns of Gene Expression. J Clin Oncol 2008;26(20):3324-3330.

  19. Carlson RW, Edge SB, Theriault RL, NCCN Breast Cancer Practice Guidelines Panel. NCCN: Breast Cancer. Cancer Control 2001;8(6 Suppl 2):54-61.

  20. Adami HO, Malker B, Holmberg L, Persson I, Stone B. The relation between survival and age at diagnosis and breast cancer. N Engl J Med 1986;315(9):559-563.

  21. Xiong Q, Valero V, Kau V, Kau SW, Taylor S, Smith TL, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis: The M.D. Anderson Cancer Center experience. Cancer 2001;92(10):2523-2528.

  22. Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY. Do young breast cancer patients have worse outcomes? J Surg Res 2003;113(1):109-113.

  23. Dowsett M, Archer C, Assersohn L, Gregory RK, Ellis PA, Salter J, et al. Clinical studies of apoptosis and proliferation in breast cancer. Endocr Relat Cancer 1999;6(1):25-28.

  24. Zemlickis D, Lishner M, Degendorfer P, Panzarella T, Burke B, Sutcliffe SB, et al. Maternal and fetal outcome after breast cancer in pregnancy. Am J Obstet Gynecol 1992;166(3):781-787.

  25. Ishida T, Yokoe T, Kasumi F, Sakamoto G, Makita M, Tominaga T, et al. Clinicopathologic Characteristics and Prognosis of Breast Cancer Patients Associated with Pregnancy and Lactation: Analysis of Case- Control Study in Japan. Jpn J Cancer Res 1992;83(11):1143-1149.

  26. Bonnier P, Romain S, Dilhuydy JM, Bonichon F, Julien JP, Charpin C, et al. Influence of pregnancy on the outcome of breast cancer: A case-control study. Int J Cancer 1997;72(5):720-727.

  27. Rodriguez AO, Chew H, Cress R, Xing G, McElvy S, Danielsen B, et al. Evidence of Poorer Survival in Pregnancy-Associated Breast Cancer. Obstet Gynecol 2008;112(1):71-78.

  28. Berry DL, Theriault RL, Holmes FA, Parisi VM, Booser DJ, Singletary SE, et al. Management of Breast Cancer During Pregnancy Using a Standarized Protocol. J Clin Oncol 1999;17(3):855-861.

  29. Ring AE, Smith IE, Jones A, Shannon C, Galani E, Ellis PA. Chemotherapy for Breast Cancer During Pregnancy: An 18-Year Experience From Five London Teaching Hospitals. J Clin Oncol 2005;23(18):4192-4197.

  30. Nettleton J, Long J, Kuban D, Wu R, Shaeffer J, El-Mahdi A. Breast cancer during pregnancy: quantifying the risk of treatment delay. Obstet Gynecol 1996;87(3):414-418.

  31. Shousha S. Breast Carcinoma Presenting During or Shortly After Pregnancy and Lactation. Arch Pathol Lab Med 2000;124(7):1053- 1060.

  32. Elledge RM, Ciocca DR, Langone G, McGuire WL. Estrogen receptor, progesterone receptor, and HER-2/neu protein in breast cancers from pregnant patients. Cancer 1993;71(8):2499-2506.

  33. Johannsson O, Loman N, Borg A, Olsson H. Pregnancy-associated breast cancer in BRCA1 and BRCA2 germline mutation carriers. Lancet 1998;352(9137):1359-1360.

  34. Daling JR, Malone KE, Voigt LF, White E, Weiss NS. Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion. J Natl Cancer Inst 1994;86(21):1584-1592.

  35. Tretli S, Kvalheim G, Thoresen S, HÃ, st H. Survival of breast cancer patients diagnosed during pregnancy or lactation. Br J Cancer 1988;58(3):382-384.

  36. Lippman ME, Dickson RB, Gelmann EP, Rosen N, Knabbe C, Bates S, et al. Growth regulation of human breast carcinoma occurs through regulated growth factor secretion. J Cell Biochem 1987;35(1):1-16.

  37. Russo J, Moral R, Balogh GA, Mailo D, Russo IH. The protective role of pregnancy in breast cancer. Breast Cancer Res 2005;7(3):131- 142.

  38. Schedin P. Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer 2006;6(4):281-291.

  39. Phillips KA, Milne RL, Friedlander ML, Jenkins MA, McCredie MRE, Giles GG, et al. Prognosis of Premenopausal Breast Cancer and Childbirth Prior to Diagnosis. J Clin Oncol 2004;22(4):699-705.

  40. White TT. Carcinoma of the Breast and Pregnancy; analysis of 920 cases collected from the literature and 22 new cases. Ann Surg 1954;139(1):9-18.

  41. Kuerer HM, Cunningham JD, Brower ST, Tartter PI. Breast carcinoma associated with pregnancy and lactation. Surg Oncol 1997;6(2):93- 98.

  42. Guinee F, Hess KR, Taylor SH, Olsson H, Möller T, Fahey T, et al: Effect of pregnancy on prognosis for young women with breast cancer. Lancet 1994;343(8913):1587-1589.

  43. Daling JR, Malone KE, Doody DR, Anderson BO, Porter PL. The Relation of Reproductive Factors to Mortality from Breast Cancer. Cancer Epidemiol Biomarkers Prev 2002;11:235-241.

  44. Ewertz M, Duffy SW, Adami HO, Kvåle G, Lund E, Meirik O, et al. Age at first birth, parity and risk of breast cancer: A meta-analysis of 8 studies from the nordic countries. Int J Cancer 1990;46(4):597- 603.

  45. E von Schoultz, Johansson H, Wilking N, Rutqvist LE. Influence of prior and subsequent pregnancy on breast cancer prognosis. J Clin Oncol 1995;13(2):430-434.

  46. Doll DC, Ringenberg QS, Yarbro JW. Antineoplastic Agents and Pregnancy. Semin Oncol 1989;16(5):337-346.




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