The Analyses Of The Prognosis Of The Breast Cancer During Pregnancy Or Followed A Recent Parity And The Retrospective Study On The Pathologic Characteristic

Part1The prognosis of breast cancer diagnosed with or subsequent topregnancy:a meta-analysis and systematic reviewWe undertook a systematic review and meta-analysis to further investigate these relationships. We searched theMEDLINE, EMBASE, Cochrane databases,and Web of Science with a cut-off date of October2014, for follow-up studiesof the long-term outcome of pregnant or recently pregnant patients diagnosed with breast cancer. Categoricaland dose-response meta-analyses were conducted to investigatethe relationships of PABC and postpartum breast cancerwithprognosis. Forty-one studies were included for PABC and the HRs for OS of was1.45(95%CIs:1.31-1.62). PABC was associated with significantly worse DFS and an increased rate of distant or visceral metastasis.Diagnosisduring pregnancy orwithin2,2-5, or>5yearspostpartumwas associated with different higher mortality risk,especially compared with nulliparity. Multivariate-regression revealed that a diagnosis made <5years postpartum was significantly and independently associated with poor prognosis. Non-linear duration-response meta-analysis revealed anegativetime-dependent association of prognosis and diagnosis.Conclusions:A diagnosis of breast cancer within5years postpartum was independently and significantly associated with a negative effect on patientprognosis. Pregnancy at the time of diagnosis was not associated with poorer prognosis.Further long-term follow-up studies are needed.Part2The tumor characteristic of breast cancer associated pregnancy or the breast cancer subsequent to pregnancyPrevious studies have shown the special tumor characteristic of PABC, but most literature based on single-arm report. And recently, the poorer prognosis of breast cancer followed recent parity has been observed. This is a systematic review and meta-analysis of the role of the interval between a recent parity and breast cancer pathological feature. Eligible studies were carefully reviewed and analyzed. A meta-analysis of46publications demonstrated that the traditional PABC with more association with advanced tumor grade, stage, lymphnode metastasis and larger tumor size, but the breast cancer during pregnancy was less significantly compared with age-matched controls. The advanced pathologic feature was observed in breast cancer subsequent to recent parity, and with the same trend depend on the time-interval. Conclusions:Breast cancer during pregnancy might be similar with common ones, while the ones followed a recent parity might appeared a more advanced clinicopathologiccharacteristic, which may result in the poor prognosis.Part3.The retrospective study on the reproductive factors with the clinicopathologic feature of breast cancer patients aged<40yearsBreast cancer patients aged <40years who had primary treatment aged <40yearsin Wuhan Union hospital between2010and2014were included in this study. We collected the reproductive and pathologic data from medical documents and the patients via structural telephone interview. We performed Logistic regression analyses on the age of menarche, age of1st-full term pregnancy, parity, oral contraceptive used or hormone replacement therapy,family history,duration of breastfeeding and the time between last paritywith age of diagnosis to explore the independent effect of these factors to the pathologic feature.There was no significant effect among the factors when the age at diagnosis was under consideration, which was different with the previous conclusion from the literature. Our study was limited,and it needs more clinical studies in China.