Pregnancy-associated breast cancer: maternal breast cancer survival over 10 years and obstetrical outcome at a university centre of women's health

Arch Gynecol Obstet. 2018 Aug;298(2):363-372. doi: 10.1007/s00404-018-4822-5. Epub 2018 Jun 21.

Abstract

Purpose: Pregnancy-associated breast cancer (PABC) is considered the second most common malignancy affecting pregnancy. The limited knowledge as to long-term survival is nonuniform. This retrospective study aims to contribute by a follow-up of pregnancies of breast cancer patients treated at a single university centre with focus on maternal long-term survival in relation to time point of diagnosis (before, during, and after pregnancy).

Methods: Data of 25 patients were reviewed for the period between 2000 and 2009 in relation to their neonatal and maternal outcome parameters as well as their maternal breast cancer outcomes by assessing maternal mortality at annual intervals up to a maximum of 10 years follow-up.

Results: Median age at diagnosis was 33 years. Maternal survival rate of the total collective came to 76% after 5 years and to 68% after 10 years. The newborns were healthy, 22% of them presented with a 1'Apgar score 5-7. Preterm delivery occurred in 53%. PABC significantly affected maternal survival compared to the national breast cancer cohort at 5 years and barely significantly at 10 years, with highly significant (p < 0.003) to significant (p < 0.01) effects at 5 and 10 years, respectively, for PABC diagnosed during and after pregnancy.

Conclusions: The present findings on survival rates suggest that maternal medical assessment at the beginning of and during further course of pregnancy should include a scrutinized thorough breast examination. Conveying/delivering special competences to monitor these high-risk pregnancies at the interface of oncological care should be considered an obligatory part of academic medical education, obstetrical training and interprofessional midwifery education.

Keywords: 10-years follow-up; Maternal breast cancer survival; Neonatal outcome; Obstetrical outcome; Pregnancy-associated breast cancer.

MeSH terms

  • Adult
  • Apgar Score
  • Birth Weight
  • Breast Neoplasms / complications
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Female
  • Humans
  • Infant, Newborn
  • Longitudinal Studies
  • Pregnancy
  • Pregnancy Complications, Neoplastic / mortality*
  • Pregnancy Complications, Neoplastic / pathology
  • Pregnancy Outcome
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome