NEW ORLEANSHaving a previous pregnancy improves the prognosis for women
who develop early-stage breast cancer later in life, according to a study
presented at the 44th Annual Meeting of the American Society for Therapeutic
Radiology and Oncology (abstract 152). The findings suggest that a more
aggressive treatment approach should be considered for those patients who
have not had a pregnancy.
Among patients 60 years of age and older, the 10-year cause-specific
survival rate was 76% in women with no prior pregnancy, compared with 92% in
women who had been pregnant earlier in life.
"This is the first report to demonstrate significant difference in outcome
for women older than 60 years of age," said lead investigator Penny R.
Anderson, MD, a radiation oncologist at Fox Chase Cancer Center. "These
results suggest that no prior pregnancy may be considered a prognostic factor
and perhaps could be used for early identification of patients who are at
higher risk of developing distant metastasis and worse outcome, and who might
benefit from a more aggressive initial treatment approach."
The study included 1,358 women with stage I/II breast cancer who had
undergone lumpectomy, axillary dissection, and radiation therapy with or
without systemic therapy between 1979 and 19961,162 women with a prior
pregnancy and 196 women who had never been pregnant. Prior pregnancy was
defined as a full-term, live birth.
Overall, the median age was 56 years. Median age at the time of first
pregnancy was 24 years. Median follow-up was 7 years. The median age of the
women with a history of pregnancy was slightly higher (57 vs 52 for the women
with no history of pregnancy). There were also differences in age
distribution, with a slightly higher percentage of older women and a higher
percentage of postmenopausal women in the group with a history of prior
Patients Older Than 60
This led the researchers to perform a multivariate analysis on outcome
variables according to age older than 60. In this multivariate analysis, no
history of prior pregnancy was an independent predictor of distant
metastasis, cause-specific survival, and overall survival.