Medline ® Abstract for Reference 88
of 'Approach to the patient following treatment for breast cancer'
Prognostic impact of pregnancy after breast cancer according to estrogen receptor status: a multicenter retrospective study.
Azim HA Jr, Kroman N, Paesmans M, Gelber S, Rotmensz N, Ameye L, De Mattos-Arruda L, Pistilli B, Pinto A, Jensen MB, Cordoba O, de Azambuja E, Goldhirsch A, Piccart MJ, Peccatori FA
J Clin Oncol. 2013;31(1):73. Epub 2012 Nov 19.
PURPOSE: We questioned the impact of pregnancy on disease-free survival (DFS) in women with history of breast cancer (BC) according to estrogen receptor (ER) status.
PATIENTS AND METHODS: A multicenter, retrospective cohort study in which patients who became pregnant any time after BC were matched (1:3) to patients with BC with similar ER, nodal status, adjuvant therapy, age, and year of diagnosis. To adjust for guaranteed time bias, each nonpregnant patient had to have a disease-free interval at least equal to the time elapsing between BC diagnosis and date of conception of the matched pregnant one. The primary objective was DFS in patients with ER-positive BC. DFS in the ER-negative cohort, whole population, and overall survival (OS) were secondary objectives. Subgroup analyses included DFS according to pregnancy outcome and BC-pregnancy interval. With a two-sidedα= 5% andβ= 20%, 645 ER-positive patients were required to detect a hazard ratio (HR) = 0.65.
RESULTS: A total of 333 pregnant patients and 874 matched nonpregnant patients were analyzed, of whom 686 patients had an ER-positive disease. No difference in DFS was observed between pregnant and nonpregnant patients in the ER-positive (HR = 0.91; 95% CI, 0.67 to 1.24, P = .55) or the ER-negative (HR = 0.75; 95% CI, 0.51 to 1.08, P = .12) cohorts. However, the pregnant group had better OS (HR = 0.72; 95% CI, 0.54 to 0.97, P = .03), with no interaction according to ER status (P = .11). Pregnancy outcome and BC-pregnancy interval did not seem to impact the risk of relapse.
CONCLUSION: Pregnancy after ER-positive BC does not seem to reduce the risk of BC recurrence.
Department of Medical Oncology, Institut Jules Bordet, UniversitéLibre de Bruxelles, Brussels, Belgium. firstname.lastname@example.org