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Purpose <p>Breast cancer diagnosed during pregnancy (PrBC) or postpartum (PPBC) is associated with a poorer prognosis, and earlier research indicated that outcomes differ based on timing of diagnosis. We updated and expanded our Dutch nationwide pregnancy-associated breast cancer (PABC) cohort, now also including patients diagnosed within one year after an interrupted pregnancy (AABC), to compare disease characteristics and prognosis across PrBC-, PPBC- and AABC subgroups and to non-PABC patients.</p> Methods <p>All breast cancer pathology reports of women &lt; 45&#xa0;years in the Netherlands (1988–2022) were screened to identify patients diagnosed with PrBC, PPBC (&lt; 12&#xa0;months postpartum) or AABC (&lt; 12&#xa0;months after pregnancy interruption). PABC patients were 1:3 matched on age and year of diagnosis to non-PABC breast cancer patients.</p> Results <p>In our PABC cohort (N = 787), the majority was diagnosed during pregnancy (n = 471, 60%). Two distinct prognostic subgroups were observed: a favorable group including trimester 1 PrBC, PPBC 6–12&#xa0;months postpartum and AABC, and an unfavorable group diagnosed later in pregnancy (trimesters 2 and 3) or shortly postpartum (&lt; 6&#xa0;months).&#xa0;PABC patients showed overall, in comparison to non-PABC controls, poorer histopathological characteristics (more grade III and triple negative tumors) and a significantly worse 5-year overall survival (77% vs. 85%), persisting in multivariable analysis (HR 1.6, 95% CI 1.06 – 2.33, <i>P</i> = 0.025).</p> Conclusions <p>PABC patients diagnosed in advanced pregnancy or shortly postpartum are most at risk for aggressive histopathology and an unfavorable prognosis. This highlights the need for in-depth analyses between specific PABC subgroups to elucidate the etiologic mechanisms involved.</p>

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Worse prognosis for breast cancer diagnosed in advanced pregnancy and shortly postpartum: an update of the Dutch pregnancy-associated breast cancer cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月12日

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  • Carsten F. J. Bakhuis,
  • Stefan Preković,
  • Britt B. M. Suelmann,
  • Janneke Verloop,
  • Pieter J. Westenend,
  • Sabine C. Linn,
  • Paul J. van Diest,
  • Elsken van der Wall,
  • Carmen van Dooijeweert

摘要

Purpose

Breast cancer diagnosed during pregnancy (PrBC) or postpartum (PPBC) is associated with a poorer prognosis, and earlier research indicated that outcomes differ based on timing of diagnosis. We updated and expanded our Dutch nationwide pregnancy-associated breast cancer (PABC) cohort, now also including patients diagnosed within one year after an interrupted pregnancy (AABC), to compare disease characteristics and prognosis across PrBC-, PPBC- and AABC subgroups and to non-PABC patients.

Methods

All breast cancer pathology reports of women < 45 years in the Netherlands (1988–2022) were screened to identify patients diagnosed with PrBC, PPBC (< 12 months postpartum) or AABC (< 12 months after pregnancy interruption). PABC patients were 1:3 matched on age and year of diagnosis to non-PABC breast cancer patients.

Results

In our PABC cohort (N = 787), the majority was diagnosed during pregnancy (n = 471, 60%). Two distinct prognostic subgroups were observed: a favorable group including trimester 1 PrBC, PPBC 6–12 months postpartum and AABC, and an unfavorable group diagnosed later in pregnancy (trimesters 2 and 3) or shortly postpartum (< 6 months). PABC patients showed overall, in comparison to non-PABC controls, poorer histopathological characteristics (more grade III and triple negative tumors) and a significantly worse 5-year overall survival (77% vs. 85%), persisting in multivariable analysis (HR 1.6, 95% CI 1.06 – 2.33, P = 0.025).

Conclusions

PABC patients diagnosed in advanced pregnancy or shortly postpartum are most at risk for aggressive histopathology and an unfavorable prognosis. This highlights the need for in-depth analyses between specific PABC subgroups to elucidate the etiologic mechanisms involved.