Loading...
Perinatal outcomes of women with gestational breast cancer in Australia and New Zealand : A prospective population-based study
Sullivan, Elizabeth Safi, Nadom Li, Zhuoyang Rémond, Marc G. W. Chen, Tina Y. T. Javid, Nasrin Dickinson, Jan E. Ives, Angela Hammarberg, Karin Anazodo, Antoinette
Sullivan, Elizabeth
Safi, Nadom
Li, Zhuoyang
Rémond, Marc G. W.
Chen, Tina Y. T.
Javid, Nasrin
Dickinson, Jan E.
Ives, Angela
Hammarberg, Karin
Anazodo, Antoinette
Abstract
Objective
To determine the epidemiology, clinical management, and outcomes of women with gestational breast cancer (GBC).
Methods
A population-based prospective cohort study was conducted in Australia and New Zealand between 2013 and 2014 using the Australasian Maternity Outcomes Surveillance System (AMOSS). Women who gave birth with a primary diagnosis of breast cancer during pregnancy were included. Data were collected on demographic and pregnancy factors, GBC diagnosis, obstetric and cancer management, and perinatal outcomes. The main outcome measures were preterm birth, maternal complications, breastfeeding, and death.
Results
Forty women with GBC (incidence 7.5/100 000 women giving birth) gave birth to 40 live-born babies. Thirty-three (82.5%) women had breast symptoms at diagnosis. Of 27 women diagnosed before 30 weeks' gestation, 85% had breast surgery and 67% had systemic therapy during pregnancy. In contrast, all 13 women diagnosed from 30 weeks had their cancer management delayed until postdelivery. There were 17 preterm deliveries; 15 were planned. Postpartum complications included the following: hemorrhage (n = 4), laparotomy (n = 1), and thrombocytopenia (n = 1). There was one late maternal death. Eighteen (45.0%) women initiated breastfeeding, including 12 of 23 women who had antenatal breast surgery. There were no perinatal deaths or congenital malformations, but 42.5% of babies were preterm, and 32.5% were admitted for higher-level neonatal care.
Conclusions
Gestational breast cancer diagnosed before 30 weeks' gestation was associated with surgical and systemic cancer care during pregnancy and planned preterm birth. In contrast, cancer treatment was deferred to postdelivery for women diagnosed from 30 weeks, reflecting the complexity of managing expectant mothers with GBC in multidisciplinary care settings.
Keywords
breast cancer, breast surgery, breastfeeding, pregnancy, preterm, systemic therapy
Date
2022
Type
Journal article
Journal
Birth
Book
Volume
49
Issue
4
Page Range
763-773
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open
Notes
© 2022 The Authors. Birth published by Wiley Periodicals LLC.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.