Pregnancy-Associated Breast Cancer in Taiwanese Women: Potential Treatment Delay and Impact on Survival

Abstract

This study investigated the clinicopathologic characteristics and survival of women diagnosed with pregnancy-associated breast cancer (PABC) in Taiwan. PABC is defined as breast cancer diagnosed during pregnancy or within 1 year after obstetric delivery. Our sample of PABC patients (N = 26) included all patients diagnosed at a major medical center in northern Taiwan from 1984 through 2009. Among these patients, 15 were diagnosed during pregnancy and 11 were diagnosed within 1 year after delivery. The comparison group included 104 patients within the same age range as the PABC patients and diagnosed with breast cancer not associated with pregnancy from 2004 through 2009 at the same hospital. Patients' initiating treatment delayed, 5-year and 10-year overall survival were delineated by stratified Kaplan-Meier estimates. Patients' characteristics were associated with initiating treatment delayed was evaluated with multivariate proportional hazards modeling. Antepartum PABC patients were younger and had longer time between diagnosis and treatment initiation than postpartum PABC patients. The predictor of treatment delayed was including birth parity, cancer stage, and pregnancy. The PABC group had larger tumors, more advanced cancer stage, and tumors with less progesterone receptor than the comparison group. The antepartum PABC patients had higher mortality than postpartum PABC and comparison groups within 5 years after diagnosis. Based on these results, we confirmed that pregnant women with breast cancer were more likely to delay treatment. Therefore, we recommend that breast cancer screening should be integrated into the prenatal and postnatal routine visits for early detection of the women's breast problems.

Association of pregnancy and mortality in women diagnosed with breast cancer: A Nationwide Population Based Study in Taiwan

“…The previous Taiwanese study showed that patients with antepartum breast cancer usually waited more time before initiating treatment than those with postpartum or nonpregnancy‐related cancer . The authors suggested that the patients may choose to delay treatments because of concerns for the baby's health .…”

“…Only three East Asian studies have examined this problem . One study collected data from a hospital in northern Taiwan from 2004 to 2009 .…”

“…14,17,18 Only three East Asian studies have examined this problem. [19][20][21] One study collected data from a hospital in northern Taiwan from 2004 to 2009. 19 The investigators found similar overall survival among patients who were diagnosed during pregnancy (n = 15), 1 year after delivery (n = 11), and nonpregnancyrelated patients (n = 104).…”

“…[19][20][21] One study collected data from a hospital in northern Taiwan from 2004 to 2009. 19 The investigators found similar overall survival among patients who were diagnosed during pregnancy (n = 15), 1 year after delivery (n = 11), and nonpregnancyrelated patients (n = 104). Another study from a medical center in Shanghai included 109 breast cancer patients diagnosed within 5 years after a full-term pregnancy and 1,274 other breast cancer patients who were diagnosed between 1990 and 2007.…”

Breast Cancer Arising from a Suspected Fibroadenoma during Pregnancy: A Case Report and Review of Literature

“…Hence it is not advised anymore, but if breast cancer is diagnosed in the early stage of gestation, cessation of pregnancy may become a more viable choice considering the risks associated with a delay in standard treatment [39]. In general, the fiveyear survival rate in PABC is similar to the non-pregnant population; however, two primary risk factors which may affect the survival rate of PABC are a history of recent pregnancy and delay in treatment for 3 to 6 months [41][42][43][44].…”