Incidence, risk factors, and obstetrical outcomes of women with breast cancer in pregnancy.
ABSTRACT Breast cancer in pregnancy is a rare condition. The objective of our study was to describe the incidence, risk factors, and obstetrical outcomes of breast cancer in pregnancy. We conducted a population-based cohort study on 8.8 million births using data from the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample from 1999-2008. The incidence of breast cancer was calculated and logistic regression analysis was used to evaluate the independent effects of demographic determinants on the diagnosis of breast cancer and to estimate the adjusted effect of breast cancer on obstetrical outcomes. There were 8,826,137 births in our cohort of which 573 cases of breast cancer were identified for an overall 10-year incidence of 6.5 cases per 100,000 births with the incidence slightly increasing over the 10-year period. Breast cancer appeared to be more common among women >35 years of age, odds ratio (OR) = 3.36 (2.84-3.97); women with private insurance plans, OR = 1.39 (1.10-1.76); and women who delivered in an urban teaching hospital, OR = 2.10 (1.44-3.06). After adjusting for baseline characteristics, women with pregnancy-associated breast cancer were more likely to have an induction of labor, OR = 2.25 (1.88, 2.70), but similar rates of gestational diabetes, preeclampsia, instrumental deliveries, and placental abruption. The incidence of breast cancer in pregnancy appears higher than previously reported with women over 35 being at greatest risk. Aside from an increased risk for induction of labor, women with breast cancer in pregnancy have similar obstetrical outcomes.
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ABSTRACT: To estimate the incidence of pregnancy-associated cancer during a 30-year period in Denmark on the basis of both births and abortions with and without age adjustment and age standardization. Using data from the nationwide Danish registries, we investigated the occurrence of pregnancy-associated cancer (defined as cancer diagnosed during pregnancy and up to 1 year after pregnancy has ended) in pregnancies resulting in a birth (live birth or stillbirth) or an abortion. We included patients with primary cancer diagnosed at ages 15-44 years during 1977-2006 according to the Danish Cancer Registry. The patients were linked to the Medical Birth Registry, the Registry for Induced Abortions, and the National Patient Registry to obtain information on pregnancies. We identified 2,426 patients with pregnancy-associated cancer. The three most frequent types were melanoma, cervical cancer, and breast cancer. We found an increase in the total numbers of all pregnancy-associated cancers from 572 cases during 1977-1986 to 1,052 cases during 1997-2006. The proportions of all pregnancy-associated cancers among all cancers increased from 5.4% to 8.3% during the same periods. The overall crude incidence rate of all pregnancy-associated cancer was 89.6 out of 100,000 pregnancies. The crude incidence increased over time, with an average annual percentage change of 2.9% (95% confidence interval [CI] 2.4-3.3). After age adjustment, the increase was still statistically significant (1.6%, 95% CI 1.1-2.1). We found a statistically significant increase in pregnancy-associated cancer during the 30-year study period. The tendency to postpone childbirth only partly explains the increase in incidence rates. LEVEL OF EVIDENCE:: III.Obstetrics and Gynecology 08/2013; · 4.37 Impact Factor
Article: Breast cancer in pregnancy.[Show abstract] [Hide abstract]
ABSTRACT: Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. Breast cancer is one of the more common malignancies to occur during pregnancy and, as more women delay childbearing, the incidence of breast cancer in pregnancy is expected to increase. This article provides an overview of diagnosis, staging, and treatment of pregnancy-associated breast cancer. Recommendations for management of breast cancer in pregnancy are discussed.Obstetrics and Gynecology Clinics of North America 09/2013; 40(3):559-71. · 1.40 Impact Factor
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ABSTRACT: The objective of this study is to evaluate the effect of autoimmune disease on the risk of venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) in pregnant women.Clinical and Applied Thrombosis/Hemostasis 10/2014; · 1.58 Impact Factor