Breast Cancer During Pregnancy: Quantifying the Risk of Treatment Delay

Nettleton, Janet; Long, Jeffrey P.; Kuban, Deborah A.; Wu, Raymond; Shaeffer, James; El‐Mahdi, Anas M.

doi:10.1016/0029-7844(95)00470-x

Cited by 179 publications

(65 citation statements)

References 19 publications

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“…2 According to DiFronzo and O'Connell, 3 breast cancer affects between 0.2 and 3.8% of all pregnant women, an incidence that is apparently increasing as a result of delayed pregnancy (later than 30 years of age) 2 and higher levels of detection (by means of mammography) of breast cancer in younger women. 1,4 One of the earliest suggestions of an association between pregnancy and unfavorable evolution of breast cancer was published by White in 1954, who noted that less than 20% of pregnant women who developed carcinoma of the breast survived for more than five years following diagnosis. 5 A number of subsequent studies have provided evidence supporting this pessimistic prognosis for PABC patients.…”

Section: Introductionmentioning

confidence: 99%

Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

Moreira¹,

Brandão²,

Soares³

et al. 2010

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Previous studies have suggested that the occurrence of pregnancy concomitantly with a diagnosis of breast cancer may affect the evolution of the neoplasia. The present study aimed to compare pregnancy-associated breast cancer (PABC) patients with non-pregnant cancer patients (controls) in relation to the time taken to diagnose the disease, tumor characteristics and mortality. DESIGN AND SETTING:A retrospective, paired case-control study was conducted at the Hospital da Santa Casa de Misericórdia and Centro de Quimioterapia Antiblástica e Imunoterapia in Belo Horizonte, Brazil. METHODS:The study involved 87 PABC and 252 control patients. The influence of covariables (interval between first symptoms and diagnosis, tumor histology, size of primary tumor, distant metastasis, grade of malignancy, hormone receptor status and axillary lymph node involvement) and the pregnancy variable on overall survival was investigated using univariate and multivariate analyses. RESULTS:The median overall survival for PABC patients of 30.1 months (95% confidence interval, CI: 19.4-40.9 months) was significantly different (P = 0.005) from that of the control group (53.1 months; 95% CI: 35.1-71.0 months). The cumulative overall survivals after five and ten years were, respectively, 29.7 and 19.2% for PABC patients, and 47.3 and 34.8% for control patients (P = 0.005). Tumor size, grade of malignancy, distant metastasis and pregnancy were independent factors that significantly modified disease prognosis. CONCLUSIONS:Pregnancy was an independent prognostic factor. The overall survival of PABC patients was shorter than that of non-pregnant patients.RESUMO CONTEXTO E OBJETIVO: Estudos prévios sugerem que a ocorrência de gravidez simultaneamente com o diagnóstico de câncer de mama pode afetar a evolução da neoplasia. O presente estudo objetivou comparar pacientes com câncer de mama associado à gravidez (PABC) e pacientes com câncer não grávidas (controles) com relação ao tempo decorrido até o diagnóstico de câncer, características tumorais e mortalidade. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo, tipo caso-controle pareado, foi conduzido no Hospital da Santa Casa de Misericórdia e Centro deQuimioterapia Antiblástica e Imunoterapia em Belo Horizonte, Brasil. MÉTODOS:O estudo envolveu 87 pacientes PABC e 252 controles. A influência das covariáveis (intervalo entre os primeiros sintomas e diagnóstico, histologia do tumor, tamanho do tumor primário, metástase a distância, grau de malignidade, dosagem de receptor hormonal e acometimento dos linfonodos axilares) e da variável gravidez sobre a sobrevida global foram avaliados através de análises univariada e multivariada. RESULTADOS:A mediana da sobrevida global para as pacientes PABC de 30,1 meses (intervalo de confiança, IC 95%: 19,4-40,9 meses) foi significativamente (P = 0,005) diferente daquela dos controles (53,1 meses; IC 95%: 35,1-71,0 meses). A sobrevida global acumulada após 5 e 10 anos foi 29,7 e 19,2% no grupo PABC e 47,3 e 34,8% nos controles. Tamanho...

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Section: Introductionmentioning

confidence: 99%

Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

Moreira¹,

Brandão²,

Soares³

et al. 2010

Sao Paulo Med. J.

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“…Diagnosis is almost always delayed (because of gestational physiologic alterations in the breast) and occurs at a younger age 15,48 . A delay of 1 month in diagnosis translates into a 0.9% increase in the odds of lymph node metastases 49 . Pregnancy-associated bca also has unfavourable biologic features related to poor prognostic outcome: high tumour grade, low hormone receptors, increased expression of her2 (human epidermal growth factor receptor 2), and high levels of Ki-67 nuclear antigen 47,50 .…”

Section: 11mentioning

confidence: 99%

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

2015

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“…6 So early diagnosis, multidisciplinary treatment in proper time not only saves the life of victim but also is sometimes valuable for the baby .We faced difficulty in this case because of improper attention from patient side and her treating physician.The reason behind this is the normal increase in density of breast tissue during pregnancy. Here we used ultrasongraphy not only to avoid exposure of the baby by mammography but also to take a USG guided FNA from proper site in same sitting.…”

Section: Case Reportmentioning

confidence: 96%

Autoimmune thyroiditis: clinical presentation in a Nepalese population

Paudel

Paudel²

2014

Nep J Med Sci

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Background: Hypothyroidism has a wide range of clinical presentations. This study was conducted to describe the clinical manifestations of chronic Hashimoto`s thyroiditis (HT) in a Nepalese population. We also tried to identify symptoms or signs characteristic for HT. Methods: During the study period, all newly diagnosed patients with hypothyroidism were interviewed about symptoms, and clinical signs were assessed. The data of hypothyroid patients were divided in two groups: TPO antibody positive and TPO antibody negative. The symptoms and signs of the two groups were analyzed and compared. Results: Among the 88 hypothyroid patients, 33 (37.5%) had positive TPO antibody levels. Female patients were more likely to be TPO antibody positive (41.3% among female and 15.4% among male). The most frequent symptoms were lethargy, cold intolerance, constipation, tingling sensation and weight gain, and the most frequent signs were facial puffiness and non-pitting pedal edema, in both groups. Statistical analysis revealed, that cold intolerance, decreased appetite and insomnia were significantly more prevalent symptoms in the TPO antibody positive group (p<0.05). Conclusion: Hashimoto`s thyroiditis is a common cause of primary hypothyroidism. It is not possible to differentiate it from the clinical presentation. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 68-71 DOI: http://dx.doi.org/10.3126/njms.v3i1.10362

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Breast Cancer During Pregnancy: Quantifying the Risk of Treatment Delay

Cited by 179 publications

References 19 publications

Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

Outcome of Patients with Pregnancy during or after Breast Cancer: A Review of the Recent Literature

Autoimmune thyroiditis: clinical presentation in a Nepalese population

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