Elucidating the clinical-pathological factors and prognosis in breast cancer young surviving women who had a subsequent pregnant

Abstract

Objective. To elucidate the impact of clinical-pathological factors on overall survival (OS) in patients who got pregnant after breast cancer treatment. Methods. Retrospective cohort of women age younger than 40 years with breast cancer history without active disease at diagnosis of postcancer pregnancy. Clinical-pathological factors were analized by age group and recent birth. Overall survival (OS) was evaluated from Kaplan-Meier method. The association between clinical-pathological factors and OS was examined using Cox proportional hazards method to estimate hazard ratio (HR) with 95% confidence intervals (CI). Results: A total of 14 patients were selected. Median age was 28.5 years (interquartile range, 26-35). Locally advanced stage (IIB-IIIB) was diagnosed in 64.3%. Patients lower than 35 years experienced more positive clinical lymph nodes (72.7%), grade 2 (63.6%) and ER/PgR-negative tumors (54.5% and 72.7%, respectively). The patients with ER-positive tumors showed an improvement non-significant at 5-year OS (87%; p = 0.097). In the bivariate analysis, patients with a higher number of pathological lymph nodes (pNs) had a 12% increase in the risk of death than those with lower number (HR = 1.12; 95% CI: 1.02 to 1.2). The multivariate model (after adjustment for number of pNs, age and tumor size) ascertained that the nodal status was the only independent predictor associated to a worse OS (HR = 1.15; 95% CI: 1.01 to 1.3). Conclusion. Pregnancy after cancer did not have a detrimental effect on survival. The patients < 35 years old group showed more unfavorable tumor features at diagnosis, which can largely explain a poorer prognosis. Nodal status was the most important prognostic factor that predicted the poor prognosis.

Breast cancer in pregnant young women: clinicohistological profile, risk of death and pregnancy outcomes

“…The NPI also predictes risk groups in PABC women or in the postpartum 21, 38 . However, Lambertini at el.…”

“…Young age at diagnosis is considered a poor prognostic factor, since has an increased risk of distant recurrence and death compared to middle and older-aged women 15, 29, 35-38 . Several studies have found a high mortality rate in younger women, particularly in ER-positive and luminal tumors 16, 25, 29, 35 .…”

“…Patients with NPI higher score significantly had a 90% increased hazard of death (unadjusted HR = 1.9, 90% CI: 1.1 to 3.2) compared with NPI lower score. Thus, the individual analysis of classical prognostic factors is not recommend to establish the ultimate prognosis 21, 38, 53 .…”

“…Young age at diagnosis is considered a poor prognostic factor, since has an increased risk of distant recurrence and death compared to middle and older-aged women 15,29,[35][36][37][38] .…”