Impact of timing of pregnancy and genetic risk on local therapy choices for young women with breast cancer

Marla Lipsyc-Sharf; Mulun Huang; Siu-Yuan Huang; Yashila K Suresh; Alissa Doll; Jennifer L Baker; Nimmi S Kapoor

doi:10.1016/j.amjsurg.2024.116060

Impact of timing of pregnancy and genetic risk on local therapy choices for young women with breast cancer

Am J Surg. 2024 Oct 29:239:116060. doi: 10.1016/j.amjsurg.2024.116060. Online ahead of print.

Authors

Marla Lipsyc-Sharf¹, Mulun Huang², Siu-Yuan Huang², Yashila K Suresh², Alissa Doll², Jennifer L Baker², Nimmi S Kapoor³

Affiliations

¹ University of California Los Angeles, Department of Medicine, Division of Hematology-Oncology, USA.
² University of California Los Angeles, Department of Surgery, Division of Surgical Oncology, USA.
³ University of California Los Angeles, Department of Surgery, Division of Surgical Oncology, USA. Electronic address: [email protected].

PMID: 39500008
DOI: 10.1016/j.amjsurg.2024.116060

Abstract

Background: It is unknown whether timing of pregnancy before, during, or after breast cancer (BC) is associated with surgical choices in young women with breast cancer.

Methods: A retrospective chart review identified patients who had a pregnancy within 5 years prior to breast cancer diagnosis (PpBC), were pregnant during breast cancer diagnosis (PrBC), or had a pregnancy within 5 years after BC diagnosis (SPBC). Chi-square test and logistic regression analysis were used to compare surgical choice-unilateral surgery (ULS) or bilateral mastectomy (BM)-between groups.

Results: Of 109 women, 36 (33.0 %) had PpBC, 18 (16.5 %) had PrBC, and 55 (50.5 %) had SPBC. 42.2 % had stage II BC and 31.2 % had triple negative BC (TNBC). 100 patients had genetic testing and 30 (30 %) had a germline pathogenic mutation. Overall, 49.5 % of women underwent BM, and this was similar between groups. On logistic regression, genetic mutation (OR 5.44, p = 0.003) and ER-negative tumor subtype (TNBC OR 11.9, p = 0.017; ER-/HER2+ OR 23.2, p = 0.015) were associated with higher rates of BM.

Conclusion: In this study, approximately half of women with pregnancy within 5 years of BC diagnosis underwent BM. Genetic predisposition and ER-negative tumor subtype was predictive of this choice while timing of pregnancy was not.