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Breast Cancer Associated With Pregnancy: A Case Control Study

Purpose: to report 15 breast cancer cases associated with pregnancy and to compare to a control group with breast ductal infiltrating carcinoma, evaluating clinical staging, metastatic axillary lymph node involvement, histopathologic aspects related to nuclear grade, histology grade and estrogen and progesterone hormonal receptors. Method: a retrospective study of 15 cases of patients with breast cancer associated with pregnancy, attended at Mastology Department in the Woman Health Reference Center, Pérola Byington Hospital, São Paulo, was done between September 1996 and April 2001. The evaluation of clinical staging, time of diagnosis and involved axillary lymph nodes was the main study basis. Also age, parity, histologic type, applied treatment, histologic characteristics regarding nuclear grade and histologic grade and the presence of hormonal receptors in the tumors were analyzed. Results: we observed that 7 patients (46.7%) presented a locally advanced breast cancer (clinical stage IIIA and IIIB) and that 3 patients (20%) presented a disseminated disease at the moment of diagnosis. The patients presented on average 2.4 involved axillary lymph nodes and in only one patient the lymph nodes were free of disease (6.6%). Regarding time of diagnosis, 40% of the tumors were diagnosed during the lactational period, 46.7% during the second trimester and 13.3% during the third trimester. The pregnant patients were compared to a control group of non-pregnant patients in the same age range, all of them with infiltrating breast carcinoma, and clinical staging, axillary lymph node involvement, nuclear grade, histologic grade and estrogen and progesterone hormonal receptors were evaluated. There was a statistically significant difference (p=0.0022) regarding clinical staging and axillary lymph node involvement (p=0.0017), and no statistically significant difference as concerns the remaining parameters. Conclusion: breast cancer associated with pregnancy is a neoplasia with a bad prognosis. There is no difference when comparing pregnant patients with non-pregnant patients in the same age range, the advanced clinical staging at the moment of diagnosis being the determinant factor for survival.

Breast; Pregnancy complications; Chemotherapy


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