Pregnancy and breast cancer: a population-based study

• Published in: Virchows Archiv : an international journal of pathology 2003-07, Vol.443 (1), p.44-50
• Main Authors: REED, W, HANNISDAL, E, SKOVLUND, E, THORESEN, S, LILLENG, P, NESLAND, J. M
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - epidemiology; Adenocarcinoma - metabolism; Adenocarcinoma - secondary; Adult; Biological and medical sciences; Biomarkers, Tumor - metabolism; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Diseases of mother, fetus and pregnancy; Female; Gynecology. Andrology. Obstetrics; Humans; Lactation; Mammary gland diseases; Medical sciences; Middle Aged; Norway - epidemiology; Population studies; Pregnancy; Pregnancy Complications, Neoplastic - epidemiology; Pregnancy Complications, Neoplastic - metabolism; Pregnancy Complications, Neoplastic - pathology; Pregnancy. Fetus. Placenta; Prognosis; Receptor, Epidermal Growth Factor - metabolism; Receptor, ErbB-2 - metabolism; Receptor, ErbB-4; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Registries; Retrospective Studies; Survival; Survival Rate; Tumors
• ISSN: 0945-6317; 1432-2307
• DOI: 10.1007/s00428-003-0817-z

The incidence of pregnancy-associated breast cancer, i.e. during pregnancy and lactation, and of pregnancy subsequent to a breast-cancer diagnosis will increase as more women choose childbearing at a later age. Few larger series are published on pregnancy-associated breast cancer. In a population-based study, we evaluated the outcome and prognostic factors in 173 breast-cancer patients. One hundred and twenty-two patients had pregnancy-associated breast cancer (20 coincident with pregnancy and 102 during lactation) and 51 patients had pregnancy subsequent to breast cancer. The median follow-up time was 151 months. Histopathological parameters and immunoreactivity for oestrogen and progesterone receptors c-erbB-2 and c-erbB-4 were studied. All three groups had tumours with high histological grade, low frequency of hormone receptors and high expression of c-erbB-2. The pregnancy and lactation groups were near identical with regard to all histopathological parameters and outcome. In the two pregnancy-associated breast-cancer groups, tumours were significantly larger, with more extensive lymph-node involvement. For node-negative tumours the respective 5- and 10-year survival rates were 62% and 50% in the pregnancy group and 60% and 50% in the lactation group. For node-positive tumours, respective 5- and 10-year survival rates were 50% and 34% in the pregnancy group and 50% and 33% in the lactation group. In the subsequent group, overall survival was high in both node-negative and -positive groups, with 5- and 10-year survival rates of 80% and 73% and 86% and 76%, respectively. Tumour size, lymph-node status, histological grade, progesterone receptor, oestrogen receptor and c-erbB-2 were significant prognostic factors in the pregnancy-associated breast-cancer patients.