Pregnancy and post-partum breast cancer: a prospective study.

Abstract

BACKGROUND:

The concomitant occurrence of breast cancer and pregnancy remains a challenging clinical situation combining ethical and medical problems. There are few prospective data on pregnancy-associated breast cancer (PABC) whose incidence continuously increases.

PATIENTS AND METHODS:

Forty patients with PABC were compared with 61 non-pregnant, age-matched patients with infiltrative breast carcinomas (BC) diagnosed and followed since 1982.

RESULTS:

Although PABC and BC tumor size, grade and type, and lymphovascular and lymphnode invasion were similar, the BC cases showed better overall--(p=0.0001) and disease-free (p-0.015) survival. Moreover, the outcome of pregnant patients was worse than post-partum patients (p=0.017). Importantly, the number of PABC patients receiving hormonotherapy was lower than the BC patients (p<0.0004), due to lower estrogen receptor (ER) (p=0.038) and progesterone receptor (PR) (p=0.008) immunohisto-chemical (IH) levels. Retrospective estrogen-regulated pS2/trefoil factor 1 (pS2/TFF1) immunohistochemitry showed no difference between PABC and BC. All the children delivered were healthy.

CONCLUSION:

Pregnancy and the post-partum period increase breast cancer aggressiveness, pregnancy being the most detrimental. PABC hormone-dependence is under-estimated using ER and PR, and pS2/TFF1 might help in its determination. Appropriate treatment does not impair child outcome.

• Authors: Carole Mathelin, Kadour Annane, Alain Treisser, Marie-Pierre Chenard, Catherine Tomasetto, Jean-Pierre Bellocq, Marie-Christine Rio
• Journal: Anticancer research (Anticancer Res) 2008 Jul-Aug Vol. 28 Issue 4C Pg. 2447-52 ISSN: 0250-7005 [Print] Greece
• PMID: 18751433 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Receptors, Estrogen
• Receptors, Progesterone
• TFF1 protein, human
• Trefoil Factor-1
• Tumor Suppressor Proteins

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Breast Neoplasms (metabolism, therapy)
• Case-Control Studies
• Female
• Humans
• Immunohistochemistry
• Male
• Postpartum Period (metabolism)
• Pregnancy
• Pregnancy Complications, Neoplastic (metabolism, therapy)
• Pregnancy Outcome
• Prospective Studies
• Receptors, Estrogen (biosynthesis)
• Receptors, Progesterone (biosynthesis)
• Trefoil Factor-1
• Tumor Suppressor Proteins (biosynthesis)