Treating Breast Cancer in Pregnancy Affords a Survival Advantage

Another compelling abstract presented at the 2010 Breast Cancer Symposium addressed the outcomes of women treated during pregnancy. While older data suggested that patients treated in pregnancy had worse disease free and overall survival when compared to outcomes of non pregnant women, an MD Anderson study demonstrated the exact opposite.

Using institutional data of patients treated at MD Anderson, including the oldest prospective registry in the nation of women treated while pregnant, enabling them to track health outcomes of both women and their offspring, Litton and colleagues were able to perform a case-control study of 75 pregnant and 150 non-pregnant women with breast cancer, matched by stage, age, and year of diagnosis. The strength of this analysis is the uniformity of treatment delivered in both groups, which consisted of multi agent chemotherapy utilizing cyclophosphamide, doxorubicin, and fluorouracil (FAC).

With a median follow up of a little over 4 years, disease free survival at five years was 74% in women treated in pregnancy, versus 56% in non-pregnant women, which was a statistically significant finding. A trend towards improved survival was also seen: 77% versus 71%, respectively.

While it is not clear why patients treated during pregnancy appear to do better, the results confirm one fact: treatment of the pregnant patient with breast cancer should not be delayed, but started as soon as possible, which is now established to be after the first trimester. The outcomes from this study also establishes an important discussion point for the woman facing this situation: she should expect to do well and, so it appears, she does not in any way face a worse prognosis than those who are not pregnant.

Reference: J. Litton, et al. Case-control analysis of patients treated with chemotherapy during pregnancy for breast cancer. 2010 Breast Cancer Symposium. Abstract 105. (Accessed 10/21/2010). Available here.