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- Title
Perinatal outcomes of women with gestational breast cancer in Australia and New Zealand: A prospective population‐based study.
- Authors
Sullivan, Elizabeth; Safi, Nadom; Li, Zhuoyang; Remond, Marc; Chen, Tina Y. T.; Javid, Nasrin; Dickinson, Jan E.; Ives, Angela; Hammarberg, Karin; Anazodo, Antoinette; Boyle, Frances; Fisher, Jane; Halliday, Lesley; Duncombe, Greg; McLintock, Claire; Wang, Alex Y.; Saunders, Christobel
- Abstract
Objective: To determine the epidemiology, clinical management, and outcomes of women with gestational breast cancer (GBC). Methods: A population‐based prospective cohort study was conducted in Australia and New Zealand between 2013 and 2014 using the Australasian Maternity Outcomes Surveillance System (AMOSS). Women who gave birth with a primary diagnosis of breast cancer during pregnancy were included. Data were collected on demographic and pregnancy factors, GBC diagnosis, obstetric and cancer management, and perinatal outcomes. The main outcome measures were preterm birth, maternal complications, breastfeeding, and death. Results: Forty women with GBC (incidence 7.5/100 000 women giving birth) gave birth to 40 live‐born babies. Thirty‐three (82.5%) women had breast symptoms at diagnosis. Of 27 women diagnosed before 30 weeks' gestation, 85% had breast surgery and 67% had systemic therapy during pregnancy. In contrast, all 13 women diagnosed from 30 weeks had their cancer management delayed until postdelivery. There were 17 preterm deliveries; 15 were planned. Postpartum complications included the following: hemorrhage (n = 4), laparotomy (n = 1), and thrombocytopenia (n = 1). There was one late maternal death. Eighteen (45.0%) women initiated breastfeeding, including 12 of 23 women who had antenatal breast surgery. There were no perinatal deaths or congenital malformations, but 42.5% of babies were preterm, and 32.5% were admitted for higher‐level neonatal care. Conclusions: Gestational breast cancer diagnosed before 30 weeks' gestation was associated with surgical and systemic cancer care during pregnancy and planned preterm birth. In contrast, cancer treatment was deferred to postdelivery for women diagnosed from 30 weeks, reflecting the complexity of managing expectant mothers with GBC in multidisciplinary care settings.
- Subjects
AUSTRALIA; NEW Zealand; BREAST tumor treatment; BREAST cancer prognosis; CANCER prognosis; EPIDEMIOLOGY of cancer; BREAST tumor diagnosis; CANCER diagnosis; CANCER-related mortality; CANCER treatment; MATERNAL health services; PREMATURE infants; CONFIDENCE intervals; POSTPARTUM hemorrhage; TIME; FISHER exact test; PREGNANCY outcomes; TREATMENT effectiveness; CANCER patients; COMPARATIVE studies; PREGNANCY complications; BREASTFEEDING; DISEASE prevalence; DESCRIPTIVE statistics; CHI-squared test; RESEARCH funding; DATA analysis software; MASTECTOMY; COMBINED modality therapy; THROMBOCYTOPENIA; BREAST tumors; CANCER patient medical care; LONGITUDINAL method; PREGNANCY
- Publication
Birth: Issues in Perinatal Care, 2022, Vol 49, Issue 4, p763
- ISSN
0730-7659
- Publication type
Article
- DOI
10.1111/birt.12642