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Surgical and obstetric outcomes of breast cancer surgery during pregnancy: a nationwide database study in Japan

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Abstract

Purpose

Although the incidence of breast cancer during pregnancy is increasing, little is known about short-term outcomes following breast cancer surgery during pregnancy. We aimed to compare the characteristics and outcomes of breast cancer surgery with and without pregnancy, and describe the obstetric outcomes following surgery.

Methods

The data of 249,257 female patients aged < 60 years who underwent breast cancer surgery between July 2010 and March 2020 were analyzed using a nationwide Japanese database; we generated a 1:10 matched-pair cohort (260 and 2597 patients with and without pregnancy, respectively) matched according to age and treatment year. We conducted multivariable analyses to compare surgical procedures and outcomes, adjusting for potential confounders in the matched-pair cohort. Additionally, we described the obstetric outcomes of patients with pregnancy.

Results

Patients with pregnancy were more likely to undergo total mastectomy [odds ratio: 1.48 (95% confidence interval: 1.13–1.94)] and axillary dissection [1.62 (1.17–2.24)], but less likely to undergo reconstruction [0.14 (0.07–0.31)], than patients without; however, postoperative complications, postoperative length of stay, and total hospitalization costs did not differ significantly with pregnancy. Additionally, some pregnant patients experienced premature delivery [n = 18 (6.9%)] and miscarriage [n = 4 (1.5%)], and 31 of 101 patients in the third trimester at breast cancer surgery underwent a cesarean section.

Conclusion

This study demonstrated significant differences regarding surgical procedures; however, there were no significant differences regarding surgical outcomes between patients who underwent breast cancer surgery with and without pregnancy. Obstetric outcomes following breast cancer surgery were also reported.

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Data availability

The datasets analyzed during the current study are not publicly available due to contracts with the hospitals providing data to the database.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907).

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Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takaaki Konishi, Kotoe Nishioka, Masahiko Tanabe & Yasuyuki Seto

  2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Takaaki Konishi, Michimasa Fujiogi, Daisuke Shigemi, Hiroki Matsui & Hideo Yasunaga

  3. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan

    Kiyohide Fushimi

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  1. Takaaki Konishi
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  2. Michimasa Fujiogi
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  8. Yasuyuki Seto
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  9. Hideo Yasunaga
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Contributions

Conceptualization: TK, MF, DS, KN; Methodology: TK, MF; Formal analysis and investigation: TK, DS, HM; Writing—original draft preparation: TK; Writing—review and editing: TK, MF, DS, HY; Funding acquisition: HY; Resources: KF, HY; Supervision: MT, SY.

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Correspondence to Takaaki Konishi.

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This study was approved by the institutional review board of the University of Tokyo [Approval No.: 3501-(3) (December 25th, 2017)].

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Konishi, T., Fujiogi, M., Shigemi, D. et al. Surgical and obstetric outcomes of breast cancer surgery during pregnancy: a nationwide database study in Japan. Breast Cancer Res Treat 195, 289–299 (2022). https://doi.org/10.1007/s10549-022-06659-4

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