Abstract
BackgroundWomen with pregnancy-associated breast cancer (PABC), i.e. diagnosed during or within 2 years of pregnancy, have a poor prognosis. We compared symptoms, diagnostics, treatments, and waiting times from first symptoms to treatment initiation in women diagnosed with PABC and non-PABC.Materials and methodsWomen diagnosed with PABC and non-PABC at ages 15–44 were identified in Swedish healthcare registers. Chart information was retrieved for 546 women (273 PABC cases and 273 age- and hospital-matched non-PABC controls) treated at 11 hospitals across Sweden between 1992 and 2009. Distributions of symptoms, diagnostics and treatments were compared. Median waiting times from initial symptoms to start of treatment, and time periods within, were estimated from Kaplan–Meier curves.ResultsInitial symptoms in women with PABC and non-PABC were similar. Women with PABC more often underwent biopsy and ultrasound than mammography at initial examination. Compared to non-PABC, rates of mastectomy and axillary clearance were higher in women with PABC, while endocrine treatment was less common. The time from symptoms to first healthcare contact was non-significantly longer in women diagnosed during or within 6 months of pregnancy. Waiting times from contact with healthcare to diagnosis and treatment were shorter or similar in women with PABC compared to women with non-PABC.ConclusionsThese findings do not support the notion that diagnostic and treatment delays following a first healthcare contact are more common in women diagnosed with breast cancer during or shortly after pregnancy. However, there was some evidence of delays in seeking healthcare among pregnant and lactating women.
Highlights
Pregnancy-associated breast cancer (PABC) is commonly defined as a breast malignancy diagnosed during pregnancy or within 1 or 2 years of delivery
Compared to women with non-pregnancy-associated breast cancer (PABC), women diagnosed during pregnancy and up to 6 months of post-delivery tended to have larger tumours (pT3: 23.7%, 25.0% (0–6 months), both non-significant), while spread to lymph nodes was more common in women diagnosed 0–6 months post-delivery
Mammography at initial examination was less commonly performed in women diagnosed during pregnancy and within 6 months of delivery [pregnancy: 69.2% vs. 92.3% in matched controls (p value < 0.01), 0–6 months: 82.1% vs. 96.4% (p-value = 0.10)]
Summary
Pregnancy-associated breast cancer (PABC) is commonly defined as a breast malignancy diagnosed during pregnancy or within 1 or 2 years of delivery. Women with pregnancy-associated breast cancer (PABC), i.e. diagnosed during or within 2 years of pregnancy, have a poor prognosis. Diagnostics, treatments, and waiting times from first symptoms to treatment initiation in women diagnosed with PABC and non-PABC. Results Initial symptoms in women with PABC and non-PABC were similar. The time from symptoms to first healthcare contact was non-significantly longer in women diagnosed during or within 6 months of pregnancy. Waiting times from contact with healthcare to diagnosis and treatment were shorter or similar in women with PABC compared to women with non-PABC. Conclusions These findings do not support the notion that diagnostic and treatment delays following a first healthcare contact are more common in women diagnosed with breast cancer during or shortly after pregnancy. There was some evidence of delays in seeking healthcare among pregnant and lactating women
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