Survival outcomes of breast cancer in pregnancy

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Abstract
854 Background: Pregnancy-associated breast carcinoma is defined as breast cancer diagnosed either during pregnancy or one year post partum. Pregnancy may delay diagnosis and/or therapy and potentially worsen outcomes. Methods: We evaluated the presentation and survival outcomes of 47 consecutive patients presenting with breast cancer during or <1 year after pregnancy at our institution between 1990 and 2001 and compared them to age- and stage-matched women drawn from a national data base. One woman with cystocsarcoma phylloides and another with a desmoid tumor are not included in this analysis. Data were collected for TNM staging, ER/PR status, type of treatments, and survival. Results: Forty-six women were white, and 24 (51%) were diagnosed while pregnant; 23 (49%) were diagnosed within 1 year of parturition. Their mean age was 33.2 years (median=33). At presentation, 80% (n=36) had clinical/pathological stage 0-II tumors; 3 presented with metastatic disease. Axillary lymph nodes were negative in 19 (42%) and positive in 58%. Family history of breast cancer was positive in 29 (67.4%). ER was positive in 10 women (25.6%), and PR was positive in 17 (43.6%). Primary therapy included breast conservation and radiation (n=26, 56.5%), modified radical mastectomy (n=18, 39.1%), or none (n=2, 4.3%). Adjuvant chemotherapy was given to 38 (84.4%); 7 of these (15.2%) had preoperative chemotherapy. With a median follow-up of 39 months, 30 patients are alive (63.8%), and 17 have died (36.2%); 26 women (55.3%) are alive with no evidence of disease and 4 are alive with disease. Using the proportional hazards model, age was not significantly associated with survival (p=0.92). Five-year survival was also compared to the NCI SEER data controlling for age and stage. Although the number of subjects in our series is small, 5-year survival proportions among women in the SEER database were not significantly different for women with pregnancy-associated breast cancer (p=0.39). Conclusion: After controlling for age and stage, pregnancy does not appear to adversely affect the outcome of treatment for breast cancer. No significant financial relationships to disclose.

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