Abstract
Conventionally, breast cancer diagnosed during pregnancy and within the years following have been referred to collectively as pregnancy-associated breast cancer. However, increasing evidence suggests that breast cancer diagnosed during pregnancy is a different entity from that diagnosed postpartum, both in terms of prognosis and biology. Given the increasing number of women who find themselves diagnosed with breast cancer during or following a pregnancy, future research and discussion should separate these two into distinct groups: breast cancer diagnosed during pregnancy and breast cancer diagnosed postpartum in an effort to enhance our understanding to inform and improve clinical management and counseling.
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References
Smith LH et al (2003) Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol 189(4):1128–1135
Van Calsteren K et al (2010) Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes. J Clin Oncol 28(4):683–689
Andersson TM et al (2009) Increasing incidence of pregnancy-associated breast cancer in Sweden. Obstet Gynecol 114(3):568–572
Raphael J, Trudeau ME, Chan K (2015) Outcome of patients with pregnancy during or after breast cancer: a review of the recent literature. Curr Oncol 22(Suppl 1):S8–S18
Abenhaim HA et al (2012) Incidence, risk factors, and obstetrical outcomes of women with breast cancer in pregnancy. Breast J 18(6):564–568
Schedin P (2006) Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer 6(4):281–291
Vinatier E et al (2009) Breast cancer during pregnancy. Eur J Obstet Gynecol Reprod Biol 147(1):9–14
Psyrri A, Burtness B (2005) Pregnancy-associated breast cancer. Cancer J 11(2):83–95
Lyons TR, Schedin PJ, Borges VF (2009) Pregnancy and breast cancer: when they collide. J Mammary Gland Biol Neoplasia 14(2):87–98
Borges VF, Schedin PJ (2012) Pregnancy-associated breast cancer. Cancer 118(13):3226–3228
Amant F et al (2013) Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study. J Clin Oncol 31(20):2532–2539
Azim HA Jr et al (2012) The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study. Acta Oncol 51(5):653–661
Azim HA Jr et al (2012) Prognosis of pregnancy-associated breast cancer: a meta-analysis of 30 studies. Cancer Treat Rev 38(7):834–842
Litton JK et al (2013) Case control study of women treated with chemotherapy for breast cancer during pregnancy as compared with nonpregnant patients with breast cancer. Oncologist 18(4):369–376
Ezzat A et al (1996) Impact of pregnancy on non-metastatic breast cancer: a case control study. Clin Oncol (R Coll Radiol) 8(6):367–370
Greene FL (1988) Gestational breast cancer: a ten-year experience. South Med J 81(12):1509–1511
Guinee VF et al (1994) Effect of pregnancy on prognosis for young women with breast cancer. Lancet 343(8913):1587–1589
Ibrahim EM et al (2000) Pregnancy-associated breast cancer: a case-control study in a young population with a high-fertility rate. Med Oncol 17(4):293–300
Nugent P, O’Connell TX (1985) Breast cancer and pregnancy. Arch Surg 120(11):1221–1224
Stensheim H et al (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
Tretli S et al (1988) Survival of breast cancer patients diagnosed during pregnancy or lactation. Br J Cancer 58(3):382–384
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
Amant F et al (2010) Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer 46(18):3158–3168
Loibl S et al (2006) Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer 106(2):237–246
O’Neill AC, DiPiro PJ, Mayer EL (2016) Staging workup in pregnant cancer patients, in managing cancer during pregnancy. In: Azim HA Jr (ed). Springer, New York, pp 17–28
Callihan EB et al (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
Johansson AL et al (2011) Increased mortality in women with breast cancer detected during pregnancy and different periods postpartum. Cancer Epidemiol Biomarkers Prev 20(9):1865–1872
Daling JR et al (2002) The relation of reproductive factors to mortality from breast cancer. Cancer Epidemiol Biomarkers Prev 11(3):235–241
Whiteman MK et al (2004) Reproductive history and mortality after breast cancer diagnosis. Obstet Gynecol 104(1):146–154
Van den Rul N et al (2011) Postpartum breast cancer behaves differently. Facts Views Vis Obgyn 3(3):183–188
Barnett GC et al (2008) Risk factors for the incidence of breast cancer: do they affect survival from the disease? J Clin Oncol 26(20):3310–3316
Asztalos S et al (2010) Gene expression patterns in the human breast after pregnancy. Cancer Prev Res (Phila) 3(3):301–311
Atabai K, Sheppard D, Werb Z (2007) Roles of the innate immune system in mammary gland remodeling during involution. J Mammary Gland Biol Neoplasia 12(1):37–45
Clarkson RW et al (2000) NF-kappaB inhibits apoptosis in murine mammary epithelia. J Biol Chem 275(17):12737–12742
Clarkson RW et al (2004) Gene expression profiling of mammary gland development reveals putative roles for death receptors and immune mediators in post-lactational regression. Breast Cancer Res 6(2):R92–R109
Lyons TR et al (2014) Cyclooxygenase-2-dependent lymphangiogenesis promotes nodal metastasis of postpartum breast cancer. J Clin Investig 124(9):3901–3912
Lyons TR et al (2011) Postpartum mammary gland involution drives progression of ductal carcinoma in situ through collagen and COX-2. Nat Med 17(9):1109–1115
Monks J et al (2002) Do inflammatory cells participate in mammary gland involution? J Mammary Gland Biol Neoplasia 7(2):163–176
O’Brien J, Schedin P (2009) Macrophages in breast cancer: do involution macrophages account for the poor prognosis of pregnancy-associated breast cancer? J Mammary Gland Biol Neoplasia 14(2):145–157
Schedin P et al (2004) Mammary ECM composition and function are altered by reproductive state. Mol Carcinog 41(4):207–220
Borges V, Elder A, Lyons T (2016) Deciphering pro-lymphangiogenic programs during mammary involution and postpartum breast cancer. Front Oncol 6(227)
Swartz MA (2014) Inflammatory lymphangiogenesis in postpartum breast tissue remodeling. J Clin Investig 124(9):3704–3707
Borges VF et al (2015) Abstract P6-08-08: postpartum breast cancer demonstrates increased liver and brain metastasis with a proposed role for postpartum involution. Cancer Res 75(9 Supplement):P6–08-08-P6-08-08
Collins LC et al (2015) Molecular phenotype of breast cancer according to time since last pregnancy in a large cohort of young women. Oncologist 20(7):713–718
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Lee, G.E., Mayer, E.L. & Partridge, A. Prognosis of pregnancy-associated breast cancer. Breast Cancer Res Treat 163, 417–421 (2017). https://doi.org/10.1007/s10549-017-4224-6
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DOI: https://doi.org/10.1007/s10549-017-4224-6
Keywords
- Pregnancy-associated breast cancer (PABC)
- Breast cancer diagnosed during pregnancy (BCP)
- Breast cancer diagnosed postpartum (BCPP)
- Prognosis