Evidence of poorer survival in pregnancy-associated breast cancer

Anne O. Rodriguez, Helen Chew, Rosemary Cress, Guibo Xing, Sherrie McElvy, Beate Danielsen, Lloyd Smith

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Objective: To compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. Methods: The California Cancer Registry (1991-1999) was linked with the California Patient Discharge Data Set to identify women with breast cancer occurring within 9 months before or 1 year after an obstetric delivery. Age-matched, non-pregnancy-associated breast cancer controls were also identified. Demographics, cancer stage, tumor size, histology, hormone receptor status, type of treatment, and survival were reviewed and compared. Predictive factors for death from breast cancer were identified using proportional hazards modeling. Results: Seven hundred ninety-seven pregnancy-associated breast cancer cases were compared with 4,177 non-pregnancy-associated breast cancer controls. Pregnancy-associated breast cancer cases were significantly more likely to have more advanced stage, larger primary tumor, hormone receptor negative tumor, and mastectomy as a component of their treatment. In survival analysis, pregnancy-associated breast cancer had a higher death rate than non-pregnancy-associated breast cancer (39.2% compared with 33.4%, P=.002). In a multivariable analysis, advancing stage (2.22-10.76 times the risk of death for stages II-IV), race (African Americans had 68% increased risk of death over non-Hispanic whites), hormone receptor-negative tumors (20% increased risk of death over receptor-positive tumors), and pregnancy (14% increased risk of death over nonpregnant women) all were significant predictors of death. Conclusion: Pregnancy-associated breast cancer presented with more advanced disease, larger tumors, and increased percentage of hormone receptor-negative tumors. When controlled for stage, race, and hormone receptor status, pregnancy-associated breast cancer cases had a slightly higher risk of death, even when only localized-stage disease was considered.

Original languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalObstetrics and Gynecology
Volume112
Issue number1
DOIs
StatePublished - Jul 2008

Fingerprint

Breast Neoplasms
Pregnancy
Survival
Neoplasms
Hormones
Obstetric Delivery
Death Domain Receptors
Mortality
Patient Discharge
Mastectomy
Pregnancy Outcome
Survival Analysis
African Americans
Registries
Histology
Demography
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Evidence of poorer survival in pregnancy-associated breast cancer. / Rodriguez, Anne O.; Chew, Helen; Cress, Rosemary; Xing, Guibo; McElvy, Sherrie; Danielsen, Beate; Smith, Lloyd.

In: Obstetrics and Gynecology, Vol. 112, No. 1, 07.2008, p. 71-78.

Research output: Contribution to journalArticle

Rodriguez, Anne O. ; Chew, Helen ; Cress, Rosemary ; Xing, Guibo ; McElvy, Sherrie ; Danielsen, Beate ; Smith, Lloyd. / Evidence of poorer survival in pregnancy-associated breast cancer. In: Obstetrics and Gynecology. 2008 ; Vol. 112, No. 1. pp. 71-78.
@article{2a4c26a6f4064b3e8810504634809ed2,
title = "Evidence of poorer survival in pregnancy-associated breast cancer",
abstract = "Objective: To compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. Methods: The California Cancer Registry (1991-1999) was linked with the California Patient Discharge Data Set to identify women with breast cancer occurring within 9 months before or 1 year after an obstetric delivery. Age-matched, non-pregnancy-associated breast cancer controls were also identified. Demographics, cancer stage, tumor size, histology, hormone receptor status, type of treatment, and survival were reviewed and compared. Predictive factors for death from breast cancer were identified using proportional hazards modeling. Results: Seven hundred ninety-seven pregnancy-associated breast cancer cases were compared with 4,177 non-pregnancy-associated breast cancer controls. Pregnancy-associated breast cancer cases were significantly more likely to have more advanced stage, larger primary tumor, hormone receptor negative tumor, and mastectomy as a component of their treatment. In survival analysis, pregnancy-associated breast cancer had a higher death rate than non-pregnancy-associated breast cancer (39.2{\%} compared with 33.4{\%}, P=.002). In a multivariable analysis, advancing stage (2.22-10.76 times the risk of death for stages II-IV), race (African Americans had 68{\%} increased risk of death over non-Hispanic whites), hormone receptor-negative tumors (20{\%} increased risk of death over receptor-positive tumors), and pregnancy (14{\%} increased risk of death over nonpregnant women) all were significant predictors of death. Conclusion: Pregnancy-associated breast cancer presented with more advanced disease, larger tumors, and increased percentage of hormone receptor-negative tumors. When controlled for stage, race, and hormone receptor status, pregnancy-associated breast cancer cases had a slightly higher risk of death, even when only localized-stage disease was considered.",
author = "Rodriguez, {Anne O.} and Helen Chew and Rosemary Cress and Guibo Xing and Sherrie McElvy and Beate Danielsen and Lloyd Smith",
year = "2008",
month = "7",
doi = "10.1097/AOG.0b013e31817c4ebc",
language = "English (US)",
volume = "112",
pages = "71--78",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Evidence of poorer survival in pregnancy-associated breast cancer

AU - Rodriguez, Anne O.

AU - Chew, Helen

AU - Cress, Rosemary

AU - Xing, Guibo

AU - McElvy, Sherrie

AU - Danielsen, Beate

AU - Smith, Lloyd

PY - 2008/7

Y1 - 2008/7

N2 - Objective: To compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. Methods: The California Cancer Registry (1991-1999) was linked with the California Patient Discharge Data Set to identify women with breast cancer occurring within 9 months before or 1 year after an obstetric delivery. Age-matched, non-pregnancy-associated breast cancer controls were also identified. Demographics, cancer stage, tumor size, histology, hormone receptor status, type of treatment, and survival were reviewed and compared. Predictive factors for death from breast cancer were identified using proportional hazards modeling. Results: Seven hundred ninety-seven pregnancy-associated breast cancer cases were compared with 4,177 non-pregnancy-associated breast cancer controls. Pregnancy-associated breast cancer cases were significantly more likely to have more advanced stage, larger primary tumor, hormone receptor negative tumor, and mastectomy as a component of their treatment. In survival analysis, pregnancy-associated breast cancer had a higher death rate than non-pregnancy-associated breast cancer (39.2% compared with 33.4%, P=.002). In a multivariable analysis, advancing stage (2.22-10.76 times the risk of death for stages II-IV), race (African Americans had 68% increased risk of death over non-Hispanic whites), hormone receptor-negative tumors (20% increased risk of death over receptor-positive tumors), and pregnancy (14% increased risk of death over nonpregnant women) all were significant predictors of death. Conclusion: Pregnancy-associated breast cancer presented with more advanced disease, larger tumors, and increased percentage of hormone receptor-negative tumors. When controlled for stage, race, and hormone receptor status, pregnancy-associated breast cancer cases had a slightly higher risk of death, even when only localized-stage disease was considered.

AB - Objective: To compare stage distribution, tumor characteristics, and survival outcome in pregnancy-associated and non-pregnancy-associated breast cancer, and to evaluate pregnancy as a risk factor for mortality in breast cancer. Methods: The California Cancer Registry (1991-1999) was linked with the California Patient Discharge Data Set to identify women with breast cancer occurring within 9 months before or 1 year after an obstetric delivery. Age-matched, non-pregnancy-associated breast cancer controls were also identified. Demographics, cancer stage, tumor size, histology, hormone receptor status, type of treatment, and survival were reviewed and compared. Predictive factors for death from breast cancer were identified using proportional hazards modeling. Results: Seven hundred ninety-seven pregnancy-associated breast cancer cases were compared with 4,177 non-pregnancy-associated breast cancer controls. Pregnancy-associated breast cancer cases were significantly more likely to have more advanced stage, larger primary tumor, hormone receptor negative tumor, and mastectomy as a component of their treatment. In survival analysis, pregnancy-associated breast cancer had a higher death rate than non-pregnancy-associated breast cancer (39.2% compared with 33.4%, P=.002). In a multivariable analysis, advancing stage (2.22-10.76 times the risk of death for stages II-IV), race (African Americans had 68% increased risk of death over non-Hispanic whites), hormone receptor-negative tumors (20% increased risk of death over receptor-positive tumors), and pregnancy (14% increased risk of death over nonpregnant women) all were significant predictors of death. Conclusion: Pregnancy-associated breast cancer presented with more advanced disease, larger tumors, and increased percentage of hormone receptor-negative tumors. When controlled for stage, race, and hormone receptor status, pregnancy-associated breast cancer cases had a slightly higher risk of death, even when only localized-stage disease was considered.

UR - http://www.scopus.com/inward/record.url?scp=48549092984&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48549092984&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e31817c4ebc

DO - 10.1097/AOG.0b013e31817c4ebc

M3 - Article

C2 - 18591310

AN - SCOPUS:48549092984

VL - 112

SP - 71

EP - 78

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 1

ER -