Skip to main content

Advertisement

SpringerLink
Log in

Clinical subtypes and prognosis of pregnancy-associated breast cancer: results from the Korean Breast Cancer Society Registry database

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

We analyzed the clinicopathologic characteristics and prognosis of pregnancy-associated breast cancer (PABC) according to clinical subtypes to better understand the characteristics of PABC.

Methods

A total of 83,792 female patients between the ages of 20 and 49 were enrolled in the Korean Breast Cancer Society Registry database from January 1, 1996 to December 31, 2015. ‘PABC’ is defined as breast cancer diagnosed during pregnancy or within 1 year after delivery. Other patients were defined as ‘non-PABC’ patients.

Results

In non-PABC patients, luminal A subtype was the most common (50.2%). In PABC patients, TNBC was the most common (40.4%) subtype, while luminal A comprised 21.2% and HER2 subtype comprised 17.3%. There was a significant difference in overall survival (OS). In non-PABC patients, TNBC had the highest HR (HR 2.3, 95% CI 2.1–2.6). In PABC patients, the luminal B subtype (HR+ HER2-high Ki67) had the highest HR at 7.0 (95% CI 1.7–29.1). In multivariate analysis of OS by subtypes, PABC patients had significantly higher HR than non-PABC patients in the HER2 subtype (HR 2.0, 95% CI 1.1–3.7) and luminal B subtype (HR+ HER2-high Ki67) (HR 4.4, 95% CI 1.6–12.3).

Conclusion

PABC showed different biologic features than non-PABC. PABC had a particularly poor prognosis in the luminal B (HR+ HER2-highKi67) and HER2 subtypes. To improve the prognosis of PABC, treatment should be considered according to subtype. Development of drugs that can be used during pregnancy is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K, Morris J, Young J (2012) Incidence and outcomes of pregnancy-associated cancer in Australia, 1994–2008: a population-based linkage study. BJOG 119(13):1572–1582

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  3. Parente JT, Amsel M, Lerner R, Chinea F (1988) Breast cancer associated with pregnancy. Obstet Gynecol 71(6 Pt 1):861–864

    CAS  PubMed  Google Scholar 

  4. Hartman EK, Eslick GD (2016) The prognosis of women diagnosed with breast cancer before, during and after pregnancy: a meta-analysis. Breast Cancer Res Treat 160(2):347–360

    Article  CAS  Google Scholar 

  5. Azim HA Jr, Peccatori FA, Brohee S, Branstetter D, Loi S, Viale G, Piccart M, Dougall WC, Pruneri G, Sotiriou C (2015) RANK-ligand (RANKL) expression in young breast cancer patients and during pregnancy. Breast Cancer Res 17:24

    Article  Google Scholar 

  6. Azim HA Jr, Brohee S, Peccatori FA, Desmedt C, Loi S, Lambrechts D, Dell’Orto P, Majjaj S, Jose V, Rotmensz N et al (2014) Biology of breast cancer during pregnancy using genomic profiling. Endocr Relat Cancer 21(4):545–554

    Article  CAS  Google Scholar 

  7. Kroman N, Mouridsen HT (2003) Prognostic influence of pregnancy before, around, and after diagnosis of breast cancer. Breast 12(6):516–521

    Article  Google Scholar 

  8. Woo JC, Yu T, Hurd TC (2003) Breast cancer in pregnancy: a literature review. Arch Surg (Chicago Ill: 1960) 138(1):91–98. (discussion 99).

    Article  Google Scholar 

  9. Johansson ALV, Andersson TM, Hsieh CC, Jirstrom K, Cnattingius S, Fredriksson I, Dickman PW, Lambe M (2018) Tumor characteristics and prognosis in women with pregnancy-associated breast cancer. Int J Cancer 142(7):1343–1354

    Article  CAS  Google Scholar 

  10. Ahn SH, Son BH, Kim SW, Kim SI, Jeong J, Ko SS, Han W (2007) Poor outcome of hormone receptor-positive breast cancer at very young age is due to tamoxifen resistance: nationwide survival data in Korea: a report from the Korean Breast Cancer Society. J Clin Oncol 25(17):2360–2368

    Article  Google Scholar 

  11. Johansson ALV, Andersson TM, Hsieh CC, Jirstrom K, Cnattingius S, Fredriksson I, Dickman PW, Lambe M (2017) Tumor characteristics and prognosis in women with pregnancy-associated breast cancer. Int J Cancer 142:1343–1354

    Google Scholar 

  12. Iqbal J, Amir E, Rochon PA, Giannakeas V, Sun P, Narod SA (2017) Association of the Timing of Pregnancy With Survival in Women With Breast Cancer. JAMA Oncol 3(5):659–665

    Article  Google Scholar 

  13. Callihan EB, Gao D, Jindal S, Lyons TR, Manthey E, Edgerton S, Urquhart A, Schedin P, Borges VF (2013) Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer. Breast Cancer Res Treat 138(2):549–559

    Article  Google Scholar 

  14. Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, Wang Y, Marcom PK, Marks JR, Febbo PG et al (2008) Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol 26(20):3324–3330

    Article  Google Scholar 

  15. Ahn SH, Hwang UK, Kwak BS, Yoon HS, Ku BK, Kang HJ, Kim JS, Ko BK, Ko CD, Yoon KS et al (2004) Prevalence of BRCA1 and BRCA2 Mutations in Korean Breast Cancer Patients. J Korean Med Sci 19(2):269–274

    Article  CAS  Google Scholar 

  16. Anglian Breast Cancer Study G (2000) Prevalence and penetrance of BRCA1 and BRCA2 mutations in a population-based series of breast cancer cases. Br J Cancer 83(10):1301–1308

    Article  Google Scholar 

  17. Kan Z, Ding Y, Kim J, Jung HH, Chung W, Lal S, Cho S, Fernandez-Banet J, Lee SK, Kim SW et al (2018) Multi-omics profiling of younger Asian breast cancers reveals distinctive molecular signatures. Nat Commun 9(1):1725

    Article  Google Scholar 

  18. Fredholm H, Eaker S, Frisell J, Holmberg L, Fredriksson I, Lindman H (2009) Breast cancer in young women: poor survival despite intensive treatment. PLoS ONE 4(11):e7695

    Article  Google Scholar 

  19. Creighton CJ (2012) The molecular profile of luminal B breast cancer. Biologics 6:289–297

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Kozak MM, Jacobson CE, von Eyben R, Walck E, Pollom EL, Telli M, Horst KC (2018) Patterns of distant failure by intrinsic breast cancer subtype in premenopausal women treated with neoadjuvant chemotherapy. Clin Breast Cancer. https://doi.org/10.1016/j.clbc.2018.04.020

    Article  PubMed  Google Scholar 

  21. Lee MK, Varzi LA, Chung DU, Cao MA, Gornbein J, Apple SK, Chang HR (2015) The effect of young age in hormone receptor positive breast cancer. BioMed Res Int. https://doi.org/10.1155/2015/325715

    Article  PubMed  PubMed Central  Google Scholar 

  22. Baselga J, Campone M, Piccart M, Burris HA III, Rugo HS, Sahmoud T, Noguchi S, Gnant M, Pritchard KI, Lebrun F et al (2012) Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 366(6):520–529

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the Korean Breast Cancer Society. This work was supported by the National Research Foundation of Korea (2017R1D1A1B03028103) and Korea University Grant (K1813171).

Author information

Authors and Affiliations

  1. Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Soo Youn Bae, Hong Kyu Kim, Ji-Young You & Seung Pil Jung

  2. Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea

    Sei Joong Kim

  3. Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea

    JungSun Lee

  4. Center for Breast Cancer, National Cancer Center, Goyang-si, Republic of Korea

    Eun Sook Lee

  5. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi, Republic of Korea

    Eun-Kyu Kim

  6. Department of Surgery, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Republic of Korea

    Ho Young Park

  7. Division of Breast & Thyroid Surgical Oncology, Department of Surgery, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Republic of Korea

    Young Jin Suh

  8. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea

    Seung Pil Jung

Authors
  1. Soo Youn Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sei Joong Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. JungSun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eun Sook Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eun-Kyu Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ho Young Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Young Jin Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hong Kyu Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ji-Young You
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Seung Pil Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seung Pil Jung.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent is not required.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (XLSX 12 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bae, S.Y., Kim, S.J., Lee, J. et al. Clinical subtypes and prognosis of pregnancy-associated breast cancer: results from the Korean Breast Cancer Society Registry database. Breast Cancer Res Treat 172, 113–121 (2018). https://doi.org/10.1007/s10549-018-4908-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-018-4908-6

Keywords

Search

Navigation