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Pregnancy-associated breast cancer: maternal breast cancer survival over 10 years and obstetrical outcome at a university centre of women’s health

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Pregnancy-associated breast cancer (PABC) is considered the second most common malignancy affecting pregnancy. The limited knowledge as to long-term survival is nonuniform. This retrospective study aims to contribute by a follow-up of pregnancies of breast cancer patients treated at a single university centre with focus on maternal long-term survival in relation to time point of diagnosis (before, during, and after pregnancy).

Methods

Data of 25 patients were reviewed for the period between 2000 and 2009 in relation to their neonatal and maternal outcome parameters as well as their maternal breast cancer outcomes by assessing maternal mortality at annual intervals up to a maximum of 10 years follow-up.

Results

Median age at diagnosis was 33 years. Maternal survival rate of the total collective came to 76% after 5 years and to 68% after 10 years. The newborns were healthy, 22% of them presented with a 1’Apgar score 5–7. Preterm delivery occurred in 53%. PABC significantly affected maternal survival compared to the national breast cancer cohort at 5 years and barely significantly at 10 years, with highly significant (p < 0.003) to significant (p < 0.01) effects at 5 and 10 years, respectively, for PABC diagnosed during and after pregnancy.

Conclusions

The present findings on survival rates suggest that maternal medical assessment at the beginning of and during further course of pregnancy should include a scrutinized thorough breast examination. Conveying/delivering special competences to monitor these high-risk pregnancies at the interface of oncological care should be considered an obligatory part of academic medical education, obstetrical training and interprofessional midwifery education.

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Abbreviations

BMI:

Body mass index

BRCA:

Breast cancer type 1 susceptibility protein

MD:

Median

MS:

Microsoft

PABC:

Pregnancy-associated breast cancer

SGA:

Small for gestational age

SPSS:

Statistical package for the social sciences version

UKT:

Universitätsklinikum Tübingen = University Hospital Tuebingen

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Acknowledgements

The authors acknowledge Clinical Cancer Register/Comprehensive Cancer Center Tübingen for granting access to the dataset.

Funding

No funding was received. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Elisabeth Simoes and Joachim Graf contributed equally.

Authors and Affiliations

  1. Department of Women’s Health, University Hospital Tübingen, Tübingen, Germany

    Elisabeth Simoes, Eva-Maria Grischke, Andreas D. Hartkopf, Markus Hahn, Martin Weiss, Harald Abele & Sara Y. Brucker

  2. Department of Women’s Health, Research Institute for Women’s Health, University Hospital Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany

    Elisabeth Simoes, Joachim Graf, Alexander N. Sokolov, Harald Seeger & Sara Y. Brucker

  3. Staff Section Social Medicine, University Hospital Tübingen, Tübingen, Germany

    Elisabeth Simoes

  4. Medical Faculty Tübingen, Dean’s Office for Students’ Affairs, Tübingen, Germany

    Joachim Graf

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  1. Elisabeth Simoes
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Contributions

Elisabeth Simoes and Joachim Graf: literature review and analysis, statistical analysis and interpretation of data, and drafting of manuscript. Alexander N. Sokolov, Eva-Maria Grischke, Martin Weiss, Harald Abele, Harald Seeger, Andreas D. Hartkopf, Markus Hahn, Sara Y. Brucker: critical revision of manuscript, analysis and interpretation of data. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Joachim Graf.

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Conflict of interest

Author Elisabeth Simoes declares that she has no conflict of interest. Author Joachim Graf declares that he has no conflict of interest. Author Alexander N. Sokolov declares that he has no conflict of interest. Author Eva-Maria Grischke declares that she has no conflict of interest. Author Andreas D. Hartkopf declares that he has no conflict of interest. Author Markus Hahn declares that he has no conflict of interest. Author Martin Weiss declares that he has no conflict of interest. Author Harald Abele declares that he has no conflict of interest. Author Harald Seeger declares that he has no conflict of interest. Author Sara Yvonne Brucker declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Since this paper makes recourse to a secondary data analysis in which anonymized data of the Comprehensive Cancer Center Tübingen were evaluated, no approval from the ethics committee was necessary according to the provisions of the Ethics Committee of the University Hospital Tübingen.

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Informed consent was obtained from all individual participants included in the study.

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Simoes, E., Graf, J., Sokolov, A.N. et al. Pregnancy-associated breast cancer: maternal breast cancer survival over 10 years and obstetrical outcome at a university centre of women’s health. Arch Gynecol Obstet 298, 363–372 (2018). https://doi.org/10.1007/s00404-018-4822-5

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