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- Title
Clinicopathological and Prognosis of Pregnancy and Lactation-Associated Breast Cancer.
- Authors
Acar, İlkin; Aydın, Oğuzhan; Cabioğlu, Neslihan; Emiroğlu, Selman; Tükenmez, Mustafa; Sezen, Fatma; Müslümanoğlu, Mahmut; İğci, Abdullah; Özmen, Vahit
- Abstract
Objective: Although breast cancer is rare during pregnancy and lactation, it has increased in recent years. Management of this cancer is determined according to the trimester of pregnancy. The aim of this study was to determine the clinical and pathological characteristics including molecular subtypes of breast cancer during pregnancy and lactation. Material and Methods: Data of 6085 patients identified in Breast Cancer Registry Program of Istanbul Medical Faculty General Surgery Breast Diseases Unit between 1989-2019 were retrospectively analyzed. Twenty-four cases were diagnosed with breast cancer during pregnancy and lactation, and their clinical and histopathological features were determined. Results: Median age is 36 (26-42). Of those, 14 (%58.3) were diagnosed during pregnancy and 10 (%41.7) during lactation. The majority of pregnant cases were in the second trimester (n=8, %57). Patients with lactation associated breast cancer were more likely to have family history compared to patients with pregnancy associated breast cancer (60% vs 7%, p=0.009). The majority of cases were cT1&T2 (n=18, %75) and 12 of cases were axilla-positive (cN1-2, %50). Neoadjuvant chemotherapy was performed in 54% (n=13) of the patients. The majority of patients with surgery (n=22) underwent mastectomy (n=17, 77%) and axillary lymph node dissection (n=15, 68%). Invasive ductal cancer (n=16, 67%) was the most common histology determined in surgical specimen (n=8, 33%). Overall, 63% (n=15) of patients had hormone receptor positive tumors, whereas cerb B2 positivity was detected in 6 patients (25%). Furthermore, most of the invasive tumors (75%) had high Ki-67 scores (>20%). Molecular subtypes were luminal-A in 3 cases (13%), luminal-B in 12 cases (52.2%), nonluminal Her2 groups in 4 cases (17.4%) and triple negative in 4 cases (17.4%). No statistical significance could be found between pregnancy or lactation groups regarding tumor characteristics. In 33.5 months follow-up period (8-120), 5 patients (21%) had distant organ metastasis in first 24 months (n=4) and between 25-36 months (n=1). The 5-year disease-free and overall survival was respectively 70.4% and 86.6%. The 5-year disease-free survival rate was found to be higher in the pregnancy group was higher than the lactation group ((87.5% vs 70.0%; p=0.190). Furthermore, 2 patients (8%) had breast cancer-related death. Conclusion: Pregnancy and lactation-related breast cancer has aggressive tumor characteristics such as high Ki-67 scores, non-luminal Her2, and triple negative molecular subtypes. Furthermore, early distant organ metastasis in the first 3 years is common in these patients that should be considered in the management of disease with poor prognosis.
- Subjects
BREAST cancer treatment; BREAST cancer surgery; CANCER in pregnancy; MASTECTOMY; LACTATION
- Publication
European Journal of Breast Health, 2019, Vol 15, pS3
- ISSN
2587-0831
- Publication type
Article