Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;22(6):753-754.
doi: 10.1016/S1470-2045(21)00183-2.

The definition of pregnancy-associated breast cancer is outdated and should no longer be used

Frédéric Amant  1 , Hanne Lefrère  2 , Virginia F Borges  3 , Elyce Cardonick  4 , Matteo Lambertini  5 , Sibylle Loibl  6 , Fedro Peccatori  7 , Ann Partridge  8 , Pepper Schedin  9
Affiliations

The definition of pregnancy-associated breast cancer is outdated and should no longer be used

Frédéric Amant et al. Lancet Oncol. 2021 Jun.
No abstract available

PubMed Disclaimer

Conflict of interest statement

ML reports an advisory role for Roche, Lilly, Novartis, and AstraZeneca; and speaker honoraria from Roche, Lilly, Novartis, Takeda, Sandoz, and Pfizer. FP reports personal fees from Ipsen and Roche. SL reports grants from AbbVie, Celgene, AstraZeneca, Amgen, Novartis, Pfizer, Daiichi-Sankyo, Immunomedics, and Roche; advisory board honoraria paid to the institution from AbbVie, Celgene, AstraZeneca, Amgen, Novartis, Pfizer, Lilly, Bristol Myers Squibb, Puma, Pierre Fabre, Merck Sharp and Dohme, and EirGenix; speaker honoraria paid to their institution from AbbVie, Celgene, AstraZeneca, Amgen, Novartis, Pfizer, and PriME/Medscape; personal fees from Chugai and Daiichi-Sankyo; honoraria for advisory board participation and speaking fees paid to the institution from Daiichi-Sankyo, Roche, and SeaGen; and has a patent pending (EP14153692.0). All other authors declare no competing interests.

Figures

Figure:
Figure:. Schematic presentation of the cellular interactions causing the worse clinical outcome of postpartum breast cancer
(A) The definition of PABC leads to conflicting clinical outcome data. When cases of PABC are differentiated between PrBC and PPBC, the worsened prognosis in this model is specifically true for PPBC. This distinction could explain the discrepancies in prognosis in published studies. (B) During pregnancy and lactation, proliferation and differentiation of the mammary gland that is purported to result in a long-term protective effect of pregnancy against breast cancer occurs. The short-term increased risk for PPBC is attributed to mammary gland involution, a process whereby mammary epithelial cells are subsequently removed by apoptosis to return the mammary gland to its prepregnant state (gentle weaning; upper panel). Involution shares numerous stromal attributes with protumour microenvironments, including immune suppression, which might lead to the formation of aggressive tumours with increased invasiveness (quick weaning; lower panel). PABC=pregnancy-associated breast cancer. PPBC=postpartum breast cancer. PrBC=breast cancer during pregnancy.
See this image and copyright information in PMC

References

    1. Lyons T, Schedin P, Borges V. Pregnancy and breast cancer: when they collide. J Mammary Gland Biol Neoplasia 2009; 14: 87–98. - PMC - PubMed
    1. Callihan E, Gao D, Jindal S, et al. Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer. Breast Cancer Res Treat 2013; 138: 549–59. - PMC - PubMed
    1. Loibl S, Han SN, von Minckwitz G, et al. Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol 2012; 13: 887–96. - PubMed
    1. Amant F, Von Minckwitz G, Han S, et al. Prognosis of women with primary breast cancer diagnosed during pregnancy: Results from an international collaborative study. J Clin Oncol 2013; 31: 2532–39. - PubMed
    1. Borges V, Elder A, Lyons T. Deciphering pro-lymphangiogenic programs during mammary involution and postpartum breast cancer. Front Oncol 2016; 6: 227. - PMC - PubMed

MeSH terms