Pregnancy and breast cancer: a population-based study

Virchows Arch. 2003 Jul;443(1):44-50. doi: 10.1007/s00428-003-0817-z. Epub 2003 May 20.

Abstract

The incidence of pregnancy-associated breast cancer, i.e. during pregnancy and lactation, and of pregnancy subsequent to a breast-cancer diagnosis will increase as more women choose childbearing at a later age. Few larger series are published on pregnancy-associated breast cancer. In a population-based study, we evaluated the outcome and prognostic factors in 173 breast-cancer patients. One hundred and twenty-two patients had pregnancy-associated breast cancer (20 coincident with pregnancy and 102 during lactation) and 51 patients had pregnancy subsequent to breast cancer. The median follow-up time was 151 months. Histopathological parameters and immunoreactivity for oestrogen and progesterone receptors c-erbB-2 and c-erbB-4 were studied. All three groups had tumours with high histological grade, low frequency of hormone receptors and high expression of c-erbB-2. The pregnancy and lactation groups were near identical with regard to all histopathological parameters and outcome. In the two pregnancy-associated breast-cancer groups, tumours were significantly larger, with more extensive lymph-node involvement. For node-negative tumours the respective 5- and 10-year survival rates were 62% and 50% in the pregnancy group and 60% and 50% in the lactation group. For node-positive tumours, respective 5- and 10-year survival rates were 50% and 34% in the pregnancy group and 50% and 33% in the lactation group. In the subsequent group, overall survival was high in both node-negative and -positive groups, with 5- and 10-year survival rates of 80% and 73% and 86% and 76%, respectively. Tumour size, lymph-node status, histological grade, progesterone receptor, oestrogen receptor and c-erbB-2 were significant prognostic factors in the pregnancy-associated breast-cancer patients.

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / secondary
  • Adult
  • Biomarkers, Tumor / metabolism
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • ErbB Receptors / metabolism
  • Female
  • Humans
  • Lactation
  • Middle Aged
  • Norway / epidemiology
  • Pregnancy
  • Pregnancy Complications, Neoplastic / epidemiology*
  • Pregnancy Complications, Neoplastic / metabolism
  • Pregnancy Complications, Neoplastic / pathology
  • Prognosis
  • Receptor, ErbB-2 / metabolism
  • Receptor, ErbB-4
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Registries
  • Retrospective Studies
  • Survival Rate

Substances

  • Biomarkers, Tumor
  • Receptors, Estrogen
  • Receptors, Progesterone
  • ERBB4 protein, human
  • ErbB Receptors
  • Receptor, ErbB-2
  • Receptor, ErbB-4