Abstract P6-10-08: Pregnancy associated breast cancer (PABC); no evidence of patients' or doctors' delays

Abstract

Abstract Background: A small, but not negligible, proportion of breast cancers in young women are detected in association with childbearing. While pregnancy usually is a period of intense medical observation, signs and symptoms of a malignancy may be overlooked or misinterpreted as pregnancy-related, resulting in diagnostic and treatment delays. Also, a delayed diagnosis in pregnant women has been suggested as a reason for the more advanced disease and poorer outcomes in women with pregnancy-associated breast cancer. Material and Methods: For the purpose of the present study, pregnancy-associated breast cancer (PABC) was defined as an invasive breast tumor diagnosed during pregnancy and up to two years post-delivery (non-PABC cases were diagnosed outside this time window, or nulliparous). Based on a systematic review of medical records for women aged 15-44 years at diagnosis with PABC and non-PABC identified in Swedish health care registers, chart information was retrieved by trained nurses for a total of 570 women (285 PABC women and 285 age and hospital matched non-PABC women) treated at 11 hospitals across Sweden between 1992 and 2009. Median waiting times from initial signs or symptoms in days to start of treatment, and time periods within, were computed using the Kaplan-Meier method and compared using the logrank test for the Kaplan-Meier curves. Dates on first symptoms were available for 122 matched PABC/non-PABC pairs, in total 244 patients. Full dates to assess and compare times between first health care contact – diagnosis – start of treatment, were available for 246 PABC/non-PABC pairs, in total 492 women. Objective: To examine and compare lengths of several defined waiting times within the time period from initial symptoms to start of treatment in women diagnosed with PABC and non-PABC. Results: Patient delay-time between first symptom and first point of contact with health care provider. Median time between first symptoms and first contact with health care was 36 days and 45 days for women with PABC and non-PABC, respectively (logrank test p-value 0.48). Time between first health care contact and diagnosis Median time between first contact and diagnosis was 7 days for both PABC and non-PABC women (logrank test p-value 0.16). Time between diagnosis and start of treatment The median waiting time from date of diagnosis to initiation of treatment was shorter in women with PABC (22 days) compared to non-PABC women (26 days) (logrank test p-value 0.14). Time between first contact and start of treatment The median delay of start of treatment from first contact with a health care provider was 34 days in PABC women and 37 days in non-PABC women. (logrank test p-value 0.14). Conclusions: Patients' delay and the time between first contact with health care and start of treatment was shorter in women with PABC compared to non-PABC. Taken together, the present results do not support the notion that diagnostic and treatment delays are more common in women diagnosed with breast cancer during or shortly after pregnancy. Citation Format: Lambe M, Fredriksson I, Johansson ALV. Pregnancy associated breast cancer (PABC); no evidence of patients' or doctors' delays. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-10-08.