Overall survival is the lowest among young women with postpartum breast cancer. (June 2022)

• Record Type: Journal Article
• Authors: Shagisultanova, Elena; Gao, Dexiang; Callihan, Eryn; Parris, Hannah J.; Risendal, Betsy; Hines, Lisa M.; Slattery, Martha L.; Baumgartner, Kathy; Schedin, Pepper; John, Esther M.; Borges, Virginia F.
• Is Part Of: European journal of cancer. Volume 168(2022)
• Page Start: 119
• Page End: 127
• Publication Date: 2022-06
• Subjects: Breast cancer -- Young women's breast cancer -- Postpartum breast cancer -- Overall survival; BCHDS Breast Cancer Health Disparities Study -- BMI body mass index -- CI confidence interval -- ER oestrogen receptor -- HER2 human epidermal growth factor receptor 2 -- HR hazard ratio -- OS overall survival -- PPBC postpartum breast cancer -- PR progestrone receptor -- TNBC triple negative breast cancer -- YWBC young women breast cancer; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2022.03.014
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: Women diagnosed with breast cancer prior to age 45 years (<45y) and within the first 5 years postpartum (postpartum breast cancer, PPBC) have the greatest risk for distal metastatic recurrence. Methods: Pooling data from the Colorado Young Women Breast Cancer cohort and the Breast Cancer Health Disparities Study (N = 2519 cases), we examined the association of parity, age, and clinical factors with overall survival (OS) of breast cancer over 15 years of follow-up. Results: Women with PPBC diagnosed at <45y had the lowest OS (p < 0.0001), while OS of nulliparous cases diagnosed at <45y did not differ from OS of cases diagnosed at 45-65y regardless of parity status. After adjustment for study site, race/ethnicity, clinical stage, year of diagnosis and stratification for oestrogen receptor status, PPBC remained an independent factor associated with poor OS. Among cases diagnosed at <45y, nulliparous cases had 1.6 times better OS (hazard ratio (HR) = 0.61, 95%CI 0.42–0.87) compared to those with PPBC, with a more pronounced survival difference among stage I breast cancers (HR = 0.30, 95%CI 0.11–0.79). Among very young women diagnosed at age ≤35y, nulliparous cases had 2.3 times better OS (HR = 0.44, 95%CI 0.23–0.84) compared to PPBC. Conclusion: Our results suggest that postpartum status is the main driver of poor prognosis in young women with breast cancer, with the strongest association in patients diagnosed at age ≤35y and in those with stage I disease. Graphical abstract: Image 1 Highlights: Postpartum breast cancer (PPBC) is diagnosed within 5 years since childbirth. In multivariate analysis, PPBC is an independent driver of poor prognosis. Young women with PPBC have the worst overall survival (OS) at 15 years of follow-up. Negative effect of PPBC on OS is the greatest in patients diagnosed at ≤35 years. Even in stage I disease, the negative effect of PPBC on OS is significant.