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Clinicopathological Features and Prognosis of Pregnancy Associated Breast Cancer – A Matched Case Control Study

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Pathology & Oncology Research

Abstract

Pregnancy Associated Breast Cancer (PABC) manifests during pregnancy or within a year following delivery. We sought to investigate differences in management, outcome, clinical, histopathology and immunohistochemistry (IHC) characteristics of PABC and matched controls in a retrospective case control study. PABC and control patients were selected from breast cancer cases of women ≤45 years, diagnosed in the 2nd Department of Pathology, Semmelweis University, Budapest, Hungary between 1998 and 2012. Histopathology information on tumor type, grade, size, T, N, lympho-vascular invasion (LVI), Nottingham Prognostic Index (NPI), associated in situ lesions and IHC charcteristics: ER, PgR, HER2, Ki67, p53 were recorded, IHC-based subtype was assessed, clinical, management and outcome data were analysed. Thirty-one breast cancer cases were pregnancy related. Clinical management data did not differ in cases and controls. Histopathology of disease at presentation was not significantly different, but NPI assessed the PABC group as having poor, whereas controls as having intermediate prognosis. Associated in situ lesion was more often high grade Extensive Intraductal Carcinoma Component (EIC) in PABC. Triple negative and LuminalB prol tumors predominated in PABC. Disease-free and overall survival was inferior compared to controls. PABC patients with LuminalB prol and Triple negative tumors had inferior outcomes. On multivariate analysis inferior prognosis of PABC was associated with pregnancy. Our study has demonstrated inferior outcome of PABC. Difference in tumor biology is reflected by the predominance of triple negative and LuminalB tumors in PABC. The strength of the study is the analysis of complete pathology and IHC data.

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Acknowledgments

The authors are grateful to Gábor Lotz MD PhD for supervising HER2 FISH assessment.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. 2nd Department of Pathology, Semmelweis University, Üllői út 93., 1091, Budapest, Hungary

    Lilla Madaras, Kristóf Attila Kovács, Attila Marcell Szász, István Kenessey, Anna-Mária Tőkés, Borbála Székely, Zsuzsanna Baranyák, Orsolya Kiss & Janina Kulka

  2. Department of Surgery, Medical Center, Hungarian Defense Forces, Róbert Károly krt. 44, 1134, Budapest, Hungary

    Zsuzsanna Baranyák

  3. Division of Oncology, 1st Department of Internal Medicine, Semmelweis University, Tömő u 25-29, 1083, Budapest, Hungary

    Magdolna Dank

  4. Hungarian Academy of Sciences, MTA-SE Tumour Progression Research Group, Budapest, Hungary

    Anna-Mária Tőkés

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  1. Lilla Madaras
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Correspondence to Lilla Madaras.

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Madaras, L., Kovács, K.A., Szász, A.M. et al. Clinicopathological Features and Prognosis of Pregnancy Associated Breast Cancer – A Matched Case Control Study. Pathol. Oncol. Res. 20, 581–590 (2014). https://doi.org/10.1007/s12253-013-9735-9

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