Highlights
- •Pregnant breast cancer patients (PrBC) have similar survival as non-pregnant controls.
- •Pregnancy does not impact the effectiveness of chemotherapy for breast cancer.
- •This cohort study supports initiation of chemotherapy for PrBC when indicated.
Abstract
Background
A diagnosis of breast cancer during pregnancy (PrBC) does not impact prognosis if
standard treatment is offered. However, caution is warranted as gestational changes
in pharmacokinetics may lead to reduced chemotherapy concentration.
Methods
Survival of PrBC patients treated with chemotherapy during pregnancy was compared
to non-pregnant breast cancer patients treated with chemotherapy, diagnosed after
2000, excluding patients older than 45 years or with a postpartum diagnosis. The data
was registered in two multicenter registries (the International Network of Cancer,
Infertility and Pregnancy and the German Breast Group). Cox proportional hazards regression
was used to compare disease-free (DFS) and overall survival (OS) between both groups,
adjusting for age, stage, grade, hormone receptor status, human epidermal growth factor
2 status and histology, weighted by propensity scoring to account for the differences
in baseline characteristics between pregnant patients and controls.
Results
In total, 662 pregnant and 2081 non-pregnant patients were selected. Pregnant patients
were more likely to have stage II breast cancer (60.1% vs 56.1%, p = 0.035), grade
3 tumors (74.0% vs 62.2%, p < 0.001), hormone receptor-negative tumors (48.4% vs 34.0%,
p < 0.001) or triple-negative breast cancer (38.9% vs 26.9%, p < 0.001). Median follow-up
was 66 months. In multivariable analysis, DFS and OS were comparable for pregnant
and non-pregnant patients (DFS: HR 1.02, 95% CI 0.82–1.27, p = 0.83; OS: HR 1.08,
95% CI 0.81–1.45, p = 0.59).
Conclusion
Outcome of women with breast cancer treated with chemotherapy during pregnancy is
comparable to young non-pregnant women. These results support chemotherapy for PrBC
when indicated.
Keywords
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Article info
Publication history
Published online: May 17, 2022
Accepted:
April 3,
2022
Received in revised form:
March 25,
2022
Received:
January 4,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
