gms | German Medical Science

Introduction: The diagnosis of breast cancer during pregnancy or up to one year after child birth is defined as a special entity of breast cancer. The incidence of pregnancy associated breast cancer (PA-BC) is estimated as 1 in 3.000 pregnancies. Data from Germany are lacking.

Methods: Data of 252 young women treated in the Universitätsfrauenklinik Heidelberg from 1987 until 2000 which where aged up to 35 years old with breast cancer were analyzed retrospectively. The size of the tumor, lymph-node status and survival rates were compared. To evaluate the follow-up all 252 women and treating medical institutions were contacted by mail.

Results: The age of the women at the time of diagnosis was 21-35 years, mean age 31.5 years. 121 (45 %) of the women had already delivered and the pregnancy had no association to the diagnosis of cancer. 99 women (39.3 %) were nullipara. Of the 252 32 women had a PA-BC, 19 diagnoses in pregnancy and 13 in the period of lactation.

Our data show, that both groups (young women with or without PA-BC) do not significantly differ considering size of tumor or axillary lymph-node status (p=0.114; p=0.392; chi-square-Test). But the 5- and 10 year survival rates show a significantly lower survival for women with PA-BC (p=0.0193; log-rank-Test).

Conclusion: It is stated that pregnancy associates breast cancer tends to have advanced stages, less often positive hormone receptors, higher histological grading, and more often positive receptors for Her-2/neu.

Our data show that although the characteristics (tumor size and lymph-node status) are comparable in young women with cancer, the survival rates are worse for the women with pregnancy associated breast cancer.

The primarily explanation for the decreased survival rate can be the delayed diagnosis and therapy. To clear this hypothesis the assessment of data of pregnancy associated breast cancer in Germany is already initiated (http://www.germanbreastgroup.de/pregnancy/).