Prognosis of Pregnancy-associated Breast Cancer: A Meta-analysis

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or the postpartum period. Deﬁnitions of the duration of the postpartum period have been controversial, and this variability may lead to diverse results regarding prognosis. Moreover, evidence on the dose-response association between the time from the last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Library for observational studies on the prognosis of PABC published up to June 1, 2019. We estimated summary-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosis time, PABC definition, geographic region, year of publication and estimation procedure for HR were performed. Additionally, dose-response analysis was conducted by using the variance weighted least-squares regression (VWLS) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC was associated with poor prognosis for overall survival (OS), disease-free survival (DFS) and cause-specific survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. The corresponding reference category was non-PABC patients. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a nonlinear association between the time from the last delivery to breast cancer diagnosis and the HR of overall mortality (P<0.001). Compared to nulliparous women, the mortality was almost 60% higher in women with PABC diagnosed at 12 months after the last delivery (HR=1.59, 95% CI 1.30-1.82), and the mortality was not significantly different at 70 months after the last delivery (HR=1.14, 95% CI 0.99-1.25). This finding suggests that the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum (70 months after the last delivery) to capture the increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum.

Download Full-text

Prognosis of Pregnancy-associated Breast Cancer: A Meta-analysis

10.21203/rs.2.17528/v2 ◽

2020 ◽

Author(s):

Chunchun SHAO ◽

Zhi gang YU ◽

Juan XIAO ◽

Li yuan LIU ◽

Fan zhen HONG ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Dose Response ◽

Poor Prognosis ◽

Meta Analysis ◽

Breast Cancer Diagnosis ◽

Response Analysis ◽

Subgroup Analyses ◽

Definition Of ◽

Overall Mortality

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or the postpartum period. Deﬁnitions of the duration of the postpartum period have been controversial, and this variability may lead to diverse results regarding prognosis. Moreover, evidence on the dose-response association between the time from the last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Library for observational studies on the prognosis of PABC published up to June 1, 2019. We estimated summary-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosis time, PABC definition, geographic region, year of publication and estimation procedure for HR were performed. Additionally, dose-response analysis was conducted by using the variance weighted least-squares regression (VWLS) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC was associated with poor prognosis for overall survival (OS), disease-free survival (DFS) and cause-specific survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. The corresponding reference category was non-PABC patients. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a nonlinear association between the time from the last delivery to breast cancer diagnosis and the HR of overall mortality ( P <0.001). Compared to nulliparous women, the mortality was almost 60% higher in women with PABC diagnosed at 30 months after the last delivery (HR=1.58, 95% CI 1.39-1.74), and the mortality was not significantly different at 68 months after the last delivery (HR=1.11, 95% CI 0.99-1.24). This finding suggests that the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum (68 months after the last delivery) to capture this ongoing increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include patients diagnosed up to approximately six years postpartum.

Download Full-text

Prognosis and Expanded Definition of Pregnancy-associated Breast Cancer: A Dose-Response Meta-Analysis

10.21203/rs.2.17528/v1 ◽

2019 ◽

Author(s):

Chunchun Shao ◽

Zhi Gang Yu ◽

Juan Xiao ◽

Li Yuan Liu ◽

Fan Zhen Hong ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Dose Response ◽

Poor Prognosis ◽

Meta Analysis ◽

Breast Cancer Diagnosis ◽

Response Analysis ◽

Subgroup Analyses ◽

Definition Of ◽

Overall Mortality

Abstract Background Pregnancy-associated breast cancer (PABC) is defined as breast cancer that is diagnosed during pregnancy and/or postpartum period. Deﬁnitions of the duration in the postpartum have controversial and this variability may led to diverse results on the prognosis. Moreover, evidence on the dose-response association between the time from last pregnancy to breast cancer diagnosis and overall mortality has not been synthesized. Methods We systematically searched PubMed, Embase, and the Cochrane Database for observational studies about the prognosis of PABC published up to June 1, 2019. We estimated summary adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Subgroup analyses based on diagnosed time, PABC definition, geographic region, year of publication and the way of HR estimate were performed. Additionally, the dose–response analysis was conducted by using the variance weighted least-squares regression (vwls) trend estimation. Results A total of 54 articles (76 studies) were included in our study. PABC is associated with poor prognosis on overall survival (OS), disease-free survival (DFS) and cause-special survival (CSS), and the pooled HRs with 95% CIs were 1.45 (1.30-1.63), 1.39 (1.25-1.54) and 1.40 (1.17-1.68), respectively. According to subgroup analyses, the varied definition of PABC led to diverse results. The dose-response analysis indicated a non-linear association between the time from last pregnancy to breast cancer diagnosis and overall mortality ( P <0.001). Compared with nulliparous women, PABC had a HR for all cause death that peaked at 1.62 (95% CI, 1.46-1.80) at 28 months since last pregnancy, starting from 78 months since last pregnancy became insignificant 1.07(95%CI, 0.99-1.26). It suggested that the definition of PABC should be extended to include cases diagnosed up to about six-years postpartum (78 months since last pregnancy) in order to capture this ongoing increased risk. Conclusion This meta-analysis suggests that PABC is associated with poor prognosis, and the definition of PABC should be extended to include cases diagnosed up to about six-years postpartum.

Download Full-text

Pregnancy Outcomes After a Breast Cancer Diagnosis: A Systematic Review and Meta-analysis

Clinical Breast Cancer ◽

10.1016/j.clbc.2017.06.016 ◽

2018 ◽

Vol 18 (1) ◽

pp. e79-e88 ◽

Cited By ~ 18

Author(s):

Brigitte Gerstl ◽

Elizabeth Sullivan ◽

Angela Ives ◽

Christobel Saunders ◽

Handan Wand ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Diagnosis ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Breast Cancer Diagnosis

Download Full-text

The mental health impacts of receiving a breast cancer diagnosis: A meta-analysis

British Journal of Cancer ◽

10.1038/s41416-021-01542-3 ◽

2021 ◽

Author(s):

Justine Fortin ◽

Mélissandre Leblanc ◽

Guillaume Elgbeili ◽

Matthew J. Cordova ◽

Marie-France Marin ◽

...

Keyword(s):

Breast Cancer ◽

Mental Health ◽

Cancer Diagnosis ◽

Meta Analysis ◽

Breast Cancer Diagnosis ◽

Health Impacts

Download Full-text

APCgene promoter aberrant methylation in serum as a biomarker for breast cancer diagnosis: A meta-analysis

Thoracic Cancer ◽

10.1111/1759-7714.12580 ◽

2018 ◽

Vol 9 (2) ◽

pp. 284-290 ◽

Cited By ~ 8

Author(s):

Xiaojun Qian ◽

Liwei Ruan

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Meta Analysis ◽

Breast Cancer Diagnosis ◽

Aberrant Methylation

Download Full-text

Alcohol Consumption by Beverage Type and Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Alcohol and Alcoholism ◽

10.1093/alcalc/agaa012 ◽

2020 ◽

Vol 55 (3) ◽

pp. 246-253 ◽

Cited By ~ 1

Author(s):

Qiuyu Sun ◽

Weihong Xie ◽

Yanli Wang ◽

Feifei Chong ◽

Mengmeng Song ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cohort Studies ◽

Postmenopausal Women ◽

Dose Response ◽

Alcohol Intake ◽

Meta Analysis ◽

Response Analysis ◽

Total Alcohol

Abstract Aims Alcohol intake has been shown to increase the risk of breast cancer. However, the dose-response analysis of different alcoholic beverages (spirits, wine and beer) is not clear. Our meta-analysis aims to provide a dose-response estimation between different alcohols and breast cancer risk. Methods Search of PubMed and Web of Science and manual searches were conducted up to 1 December 2018, and summary relative risks (RRs) and attributable risk percentage (ARP) for alcohol intake on the development of breast cancer were calculated. Dose-response meta-analysis modeled relationships between drinking type and breast cancer risk. Sources of heterogeneity were explored, and sensitivity analyses were conducted to test the robustness of findings. Results In total, 22 cohort studies and 45,350 breast cancer cases were included. Current drinkers for ER+ had an increased risk compared with never drinkers. In dose-response analysis, there was a statistically significant linear trend with breast cancer risk increasing gradually by total alcohol and wine dose: when adding 10 g per day, the risk increased by 10.5% (RR = 1.10, 95%CI = 1.08–1.13) in total alcohol and 8.9% (RR = 1.08, 95%CI = 1.04–1.14) in wine. For postmenopausal women, the risk increases by 11.1% (RR = 1.11, 95%CI = 1.09–1.13) with every 10 g of total alcohol increase. Furthermore, the breast cancer alcohol-attributed percentage is higher in Europe than in North America and Asia. Conclusions The effect of drinking on the incidence of breast cancer is mainly manifested in ER+ breast cancer. Quantitative analysis showed total drinking had a significant risk for breast cancer, especially for postmenopausal women. However, for different alcohols, just wine intake has the similar results.

Download Full-text