Purpose: We performed a mono-institutional study for evaluating the biological data, such as p53, Ki67 and BRCA mutations, as well as clinical characteristics of pregnancy associated breast cancer (PABC), its therapeutic management and the prognosis in a small cohort of patients.
Materials and methods: We retrospectively examined 26 patients with PABC. Clinical and histopathological characteristics along with Ki67, p53 and BRCA mutations were analysed. Information about chemotherapy, surgery and radiotherapy was recovered. Data about long-term prognosis was registered and computed by Kaplan-Meier analysis.
Results: Of 26 patients, 17 (65%) were considered as having a locally advanced breast cancer. The majority of them (65.4%) had a ductal invasive carcinoma. Oestrogen and progesterone receptors were positive in 13 (50%) patients, resulting both negative in four (15.4%) subjects. HER-2 was positive in 5 subjects (19.2%). Ten patients underwent conservative surgery treatment, and 14 were sent to radical mastectomy (38 vs. 54%) associated with axillary lymph node dissection in 18 cases. Many patients (65%) were further treated with adjuvant chemotherapy and/or hormone therapy. Eight out of 11 patients undergoing the evaluation of BRCA mutation were positive while only 2 out of 3 patients had a mutation of p53. After a median follow-up of 110 months (range: 8.2-1227 mo.), 18 women were still alive, six patients (25%) died and two were lost. Three patients showed a loco-regional recurrence, after a median period of 26 months (range: 2-42 mo.). Distant metastases verified in six patients after a median period of 12.5 months (range: 2-108 mo.). The prognosis was less favourable in BRCA mutated patients than no-BRCA mutated group, although not statistically significant.
Conclusions: In women with PABC, the initial stage of disease is more advanced requiring more aggressive treatment.
Keywords: Pregnancy associated breast cancer; Prognosis; Surgery; Treatment.
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