Prognosis of Women With Primary Breast Cancer Diagnosed During Pregnancy: Results From an International Collaborative Study
We aimed to determine the prognosis of patients with breast cancer diagnosed during pregnancy (BCP). In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and retrospectively between 2003 and 2011 was compar...
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| Veröffentlicht in: | Journal of clinical oncology 2013-07, Vol.31 (20), p.2532-2539 |
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| creator | AMANT, Frédéric VON MINCKWITZ, Gunter NEVEN, Patrick WESTENEND, Pieter J MÜLLER, Volkmar VAN CALSTEREN, Kristel RACK, Brigitte NEKLJUDOVA, Valentina HARBECK, Nadia UNTCH, Michael WITTEVEEN, Petronella O SCHWEDLER, Kathrin HAN, Sileny N THOMSSEN, Christoph VAN CALSTER, Ben LOIBL, Sibylle BONTENBAL, Marijke RING, Alistair E GIERMEK, Jerzy WILDIERS, Hans FEHM, Tanja LINN, Sabine C SCHLEHE, Bettina |
| description | We aimed to determine the prognosis of patients with breast cancer diagnosed during pregnancy (BCP).
In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and retrospectively between 2003 and 2011 was compared with patients who did not have associated pregnancies, using an age limit of 45 years. Patients with a diagnosis postpartum were excluded. The main analysis was performed using Cox proportional hazards regression of disease-free survival (DFS) and overall survival (OS) on exposure (pregnant or not), adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status, histology, type of chemotherapy, use of trastuzumab, radiotherapy, and hormone therapy.
The registry contained 447 women with BCP, mainly originating from Germany and Belgium, of whom 311 (69.6%) were eligible for analysis. The nonpregnant group consisted of 865 women. Median age was 33 years for the pregnant and 41 years for the nonpregnant patients. Median follow-up was 61 months. The hazard ratio of pregnancy was 1.34 (95% CI, 0.93 to 1.91; P = .14) for DFS and 1.19 (95% CI, 0.73 to 1.93; P = .51) for OS. Cox regression estimated that the 5-year DFS rate for pregnant patients would have increased from 65% to 71% if these patients had not been pregnant. Likewise, the 5-year OS rate would have increased from 78% to 81%.
The results show similar OS for patients diagnosed with BCP compared with nonpregnant patients. This information is important when patients are counseled and supports the option to start treatment with continuation of pregnancy. |
| doi_str_mv | 10.1200/JCO.2012.45.6335 |
| format | Article |
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In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and retrospectively between 2003 and 2011 was compared with patients who did not have associated pregnancies, using an age limit of 45 years. Patients with a diagnosis postpartum were excluded. The main analysis was performed using Cox proportional hazards regression of disease-free survival (DFS) and overall survival (OS) on exposure (pregnant or not), adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status, histology, type of chemotherapy, use of trastuzumab, radiotherapy, and hormone therapy.
The registry contained 447 women with BCP, mainly originating from Germany and Belgium, of whom 311 (69.6%) were eligible for analysis. The nonpregnant group consisted of 865 women. Median age was 33 years for the pregnant and 41 years for the nonpregnant patients. Median follow-up was 61 months. The hazard ratio of pregnancy was 1.34 (95% CI, 0.93 to 1.91; P = .14) for DFS and 1.19 (95% CI, 0.73 to 1.93; P = .51) for OS. Cox regression estimated that the 5-year DFS rate for pregnant patients would have increased from 65% to 71% if these patients had not been pregnant. Likewise, the 5-year OS rate would have increased from 78% to 81%.
The results show similar OS for patients diagnosed with BCP compared with nonpregnant patients. This information is important when patients are counseled and supports the option to start treatment with continuation of pregnancy.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2012.45.6335</identifier><identifier>PMID: 23610117</identifier><language>eng</language><publisher>Alexandria, VA: American Society of Clinical Oncology</publisher><subject>Adult ; Belgium ; Biological and medical sciences ; Biopsy, Needle ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Cause of Death ; Cohort Studies ; Combined Modality Therapy - methods ; Confidence Intervals ; Disease-Free Survival ; Female ; Germany ; Gynecology. Andrology. Obstetrics ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Mammary gland diseases ; Medical sciences ; Middle Aged ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Pregnancy ; Pregnancy Complications, Neoplastic - diagnosis ; Pregnancy Complications, Neoplastic - mortality ; Pregnancy Complications, Neoplastic - therapy ; Prognosis ; Proportional Hazards Models ; Reference Values ; Registries ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Treatment Outcome ; Tumors</subject><ispartof>Journal of clinical oncology, 2013-07, Vol.31 (20), p.2532-2539</ispartof><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-aea6b8372e07741e203f68d1497ef355cc0e978315398a6aa728d97788af3dda3</citedby><cites>FETCH-LOGICAL-c403t-aea6b8372e07741e203f68d1497ef355cc0e978315398a6aa728d97788af3dda3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,3733,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27530595$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23610117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>AMANT, Frédéric</creatorcontrib><creatorcontrib>VON MINCKWITZ, Gunter</creatorcontrib><creatorcontrib>NEVEN, Patrick</creatorcontrib><creatorcontrib>WESTENEND, Pieter J</creatorcontrib><creatorcontrib>MÜLLER, Volkmar</creatorcontrib><creatorcontrib>VAN CALSTEREN, Kristel</creatorcontrib><creatorcontrib>RACK, Brigitte</creatorcontrib><creatorcontrib>NEKLJUDOVA, Valentina</creatorcontrib><creatorcontrib>HARBECK, Nadia</creatorcontrib><creatorcontrib>UNTCH, Michael</creatorcontrib><creatorcontrib>WITTEVEEN, Petronella O</creatorcontrib><creatorcontrib>SCHWEDLER, Kathrin</creatorcontrib><creatorcontrib>HAN, Sileny N</creatorcontrib><creatorcontrib>THOMSSEN, Christoph</creatorcontrib><creatorcontrib>VAN CALSTER, Ben</creatorcontrib><creatorcontrib>LOIBL, Sibylle</creatorcontrib><creatorcontrib>BONTENBAL, Marijke</creatorcontrib><creatorcontrib>RING, Alistair E</creatorcontrib><creatorcontrib>GIERMEK, Jerzy</creatorcontrib><creatorcontrib>WILDIERS, Hans</creatorcontrib><creatorcontrib>FEHM, Tanja</creatorcontrib><creatorcontrib>LINN, Sabine C</creatorcontrib><creatorcontrib>SCHLEHE, Bettina</creatorcontrib><title>Prognosis of Women With Primary Breast Cancer Diagnosed During Pregnancy: Results From an International Collaborative Study</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>We aimed to determine the prognosis of patients with breast cancer diagnosed during pregnancy (BCP).
In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and retrospectively between 2003 and 2011 was compared with patients who did not have associated pregnancies, using an age limit of 45 years. Patients with a diagnosis postpartum were excluded. The main analysis was performed using Cox proportional hazards regression of disease-free survival (DFS) and overall survival (OS) on exposure (pregnant or not), adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status, histology, type of chemotherapy, use of trastuzumab, radiotherapy, and hormone therapy.
The registry contained 447 women with BCP, mainly originating from Germany and Belgium, of whom 311 (69.6%) were eligible for analysis. The nonpregnant group consisted of 865 women. Median age was 33 years for the pregnant and 41 years for the nonpregnant patients. Median follow-up was 61 months. The hazard ratio of pregnancy was 1.34 (95% CI, 0.93 to 1.91; P = .14) for DFS and 1.19 (95% CI, 0.73 to 1.93; P = .51) for OS. Cox regression estimated that the 5-year DFS rate for pregnant patients would have increased from 65% to 71% if these patients had not been pregnant. Likewise, the 5-year OS rate would have increased from 78% to 81%.
The results show similar OS for patients diagnosed with BCP compared with nonpregnant patients. This information is important when patients are counseled and supports the option to start treatment with continuation of pregnancy.</description><subject>Adult</subject><subject>Belgium</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Needle</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy - methods</subject><subject>Confidence Intervals</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Germany</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Kaplan-Meier Estimate</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Neoplastic - diagnosis</subject><subject>Pregnancy Complications, Neoplastic - mortality</subject><subject>Pregnancy Complications, Neoplastic - therapy</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Reference Values</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1v1DAQhi0Eokvhzgn5guCSxfbEscOtpBSKKrXiQ-VmeZPJrqvELnYCWvHncbQLnEajeead0UPIc87WXDD25lNzvRaMi3Up1xWAfEBWXApVKCXlQ7JiCkTBNXw_IU9SumOMlxrkY3IioOKMc7Uiv29i2PqQXKKhp7dhRE9v3bSjN9GNNu7pu4g2TbSxvsVIz51daOzo-Ryd32YMtz7P9m_pZ0zzMCV6EcNIraeXfsLo7eSCtwNtwjDYTYi5_4n0yzR3-6fkUW-HhM-O9ZR8u3j_tflYXF1_uGzOroq2ZDAVFm210aAEMqVKjoJBX-mOl7XCHqRsW4a10sAl1NpW1iqhu1oprW0PXWfhlLw-5N7H8GPGNJnRpRbzPx7DnAyHumZSMl5nlB3QNoaUIvbm_uDBcGYW5SYrN4tyU0qzKM8rL47p82bE7t_CX8cZeHkEbGrt0Mesy6X_nJLAZL0EvTpwO7fd_XIRTRrtMORYYe7aADzfNUKCgD-Fg5c0</recordid><startdate>20130710</startdate><enddate>20130710</enddate><creator>AMANT, Frédéric</creator><creator>VON MINCKWITZ, Gunter</creator><creator>NEVEN, Patrick</creator><creator>WESTENEND, Pieter J</creator><creator>MÜLLER, Volkmar</creator><creator>VAN CALSTEREN, Kristel</creator><creator>RACK, Brigitte</creator><creator>NEKLJUDOVA, Valentina</creator><creator>HARBECK, Nadia</creator><creator>UNTCH, Michael</creator><creator>WITTEVEEN, Petronella O</creator><creator>SCHWEDLER, Kathrin</creator><creator>HAN, Sileny N</creator><creator>THOMSSEN, Christoph</creator><creator>VAN CALSTER, Ben</creator><creator>LOIBL, Sibylle</creator><creator>BONTENBAL, Marijke</creator><creator>RING, Alistair E</creator><creator>GIERMEK, Jerzy</creator><creator>WILDIERS, Hans</creator><creator>FEHM, Tanja</creator><creator>LINN, Sabine C</creator><creator>SCHLEHE, Bettina</creator><general>American Society of Clinical Oncology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130710</creationdate><title>Prognosis of Women With Primary Breast Cancer Diagnosed During Pregnancy: Results From an International Collaborative Study</title><author>AMANT, Frédéric ; VON MINCKWITZ, Gunter ; NEVEN, Patrick ; WESTENEND, Pieter J ; MÜLLER, Volkmar ; VAN CALSTEREN, Kristel ; RACK, Brigitte ; NEKLJUDOVA, Valentina ; HARBECK, Nadia ; UNTCH, Michael ; WITTEVEEN, Petronella O ; SCHWEDLER, Kathrin ; HAN, Sileny N ; THOMSSEN, Christoph ; VAN CALSTER, Ben ; LOIBL, Sibylle ; BONTENBAL, Marijke ; RING, Alistair E ; GIERMEK, Jerzy ; WILDIERS, Hans ; FEHM, Tanja ; LINN, Sabine C ; SCHLEHE, Bettina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-aea6b8372e07741e203f68d1497ef355cc0e978315398a6aa728d97788af3dda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Belgium</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Needle</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy - methods</topic><topic>Confidence Intervals</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Germany</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Kaplan-Meier Estimate</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Neoplastic - diagnosis</topic><topic>Pregnancy Complications, Neoplastic - mortality</topic><topic>Pregnancy Complications, Neoplastic - therapy</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Reference Values</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>AMANT, Frédéric</creatorcontrib><creatorcontrib>VON MINCKWITZ, Gunter</creatorcontrib><creatorcontrib>NEVEN, Patrick</creatorcontrib><creatorcontrib>WESTENEND, Pieter J</creatorcontrib><creatorcontrib>MÜLLER, Volkmar</creatorcontrib><creatorcontrib>VAN CALSTEREN, Kristel</creatorcontrib><creatorcontrib>RACK, Brigitte</creatorcontrib><creatorcontrib>NEKLJUDOVA, Valentina</creatorcontrib><creatorcontrib>HARBECK, Nadia</creatorcontrib><creatorcontrib>UNTCH, Michael</creatorcontrib><creatorcontrib>WITTEVEEN, Petronella O</creatorcontrib><creatorcontrib>SCHWEDLER, Kathrin</creatorcontrib><creatorcontrib>HAN, Sileny N</creatorcontrib><creatorcontrib>THOMSSEN, Christoph</creatorcontrib><creatorcontrib>VAN CALSTER, Ben</creatorcontrib><creatorcontrib>LOIBL, Sibylle</creatorcontrib><creatorcontrib>BONTENBAL, Marijke</creatorcontrib><creatorcontrib>RING, Alistair E</creatorcontrib><creatorcontrib>GIERMEK, Jerzy</creatorcontrib><creatorcontrib>WILDIERS, Hans</creatorcontrib><creatorcontrib>FEHM, Tanja</creatorcontrib><creatorcontrib>LINN, Sabine C</creatorcontrib><creatorcontrib>SCHLEHE, Bettina</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>AMANT, Frédéric</au><au>VON MINCKWITZ, Gunter</au><au>NEVEN, Patrick</au><au>WESTENEND, Pieter J</au><au>MÜLLER, Volkmar</au><au>VAN CALSTEREN, Kristel</au><au>RACK, Brigitte</au><au>NEKLJUDOVA, Valentina</au><au>HARBECK, Nadia</au><au>UNTCH, Michael</au><au>WITTEVEEN, Petronella O</au><au>SCHWEDLER, Kathrin</au><au>HAN, Sileny N</au><au>THOMSSEN, Christoph</au><au>VAN CALSTER, Ben</au><au>LOIBL, Sibylle</au><au>BONTENBAL, Marijke</au><au>RING, Alistair E</au><au>GIERMEK, Jerzy</au><au>WILDIERS, Hans</au><au>FEHM, Tanja</au><au>LINN, Sabine C</au><au>SCHLEHE, Bettina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognosis of Women With Primary Breast Cancer Diagnosed During Pregnancy: Results From an International Collaborative Study</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2013-07-10</date><risdate>2013</risdate><volume>31</volume><issue>20</issue><spage>2532</spage><epage>2539</epage><pages>2532-2539</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>We aimed to determine the prognosis of patients with breast cancer diagnosed during pregnancy (BCP).
In this cohort study, a multicentric registry of patients with BCP (from Cancer in Pregnancy, Leuven, Belgium, and GBG 29/BIG 02-03) compiled pro- and retrospectively between 2003 and 2011 was compared with patients who did not have associated pregnancies, using an age limit of 45 years. Patients with a diagnosis postpartum were excluded. The main analysis was performed using Cox proportional hazards regression of disease-free survival (DFS) and overall survival (OS) on exposure (pregnant or not), adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor 2 status, histology, type of chemotherapy, use of trastuzumab, radiotherapy, and hormone therapy.
The registry contained 447 women with BCP, mainly originating from Germany and Belgium, of whom 311 (69.6%) were eligible for analysis. The nonpregnant group consisted of 865 women. Median age was 33 years for the pregnant and 41 years for the nonpregnant patients. Median follow-up was 61 months. The hazard ratio of pregnancy was 1.34 (95% CI, 0.93 to 1.91; P = .14) for DFS and 1.19 (95% CI, 0.73 to 1.93; P = .51) for OS. Cox regression estimated that the 5-year DFS rate for pregnant patients would have increased from 65% to 71% if these patients had not been pregnant. Likewise, the 5-year OS rate would have increased from 78% to 81%.
The results show similar OS for patients diagnosed with BCP compared with nonpregnant patients. This information is important when patients are counseled and supports the option to start treatment with continuation of pregnancy.</abstract><cop>Alexandria, VA</cop><pub>American Society of Clinical Oncology</pub><pmid>23610117</pmid><doi>10.1200/JCO.2012.45.6335</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical oncology, 2013-07, Vol.31 (20), p.2532-2539 |
| issn | 0732-183X 1527-7755 |
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| source | MEDLINE; American Society of Clinical Oncology Online Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Belgium Biological and medical sciences Biopsy, Needle Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Cause of Death Cohort Studies Combined Modality Therapy - methods Confidence Intervals Disease-Free Survival Female Germany Gynecology. Andrology. Obstetrics Humans Immunohistochemistry Kaplan-Meier Estimate Mammary gland diseases Medical sciences Middle Aged Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Pregnancy Pregnancy Complications, Neoplastic - diagnosis Pregnancy Complications, Neoplastic - mortality Pregnancy Complications, Neoplastic - therapy Prognosis Proportional Hazards Models Reference Values Registries Retrospective Studies Risk Assessment Survival Analysis Treatment Outcome Tumors |
| title | Prognosis of Women With Primary Breast Cancer Diagnosed During Pregnancy: Results From an International Collaborative Study |
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