A case–control study comparing breast cancer risk factors and clinicopathologic features among pregnant versus nonpregnant women at a tertiary hospital in Ibadan, North West Nigeria

Abstract

Background: There is a preponderance of incidence of breast cancer women in the reproductive age group which makes them more susceptible to Pregnancy-Associated Breast Cancer (PABC). PABC is associated with diagnostic as well as related ethical and management challenges. This study reviews the socio-demographic and clinico-pathologic findings and associated risks in patients with PABC.

Methods: Patients with histologically diagnosed breast cancer from January 2014 – December 2018 were included. PABC was defined as breast cancer diagnosed during pregnancy or within 18months of delivery. Data accrued from records included patient demographics, clinico-pathologic profile, immunohistochemistry report, interventions offered and clinical outcomes. Statistical analysis was done with the Statistical Package for the Social Sciences (SPSS) version 20.

Results: 816 patients were recruited. 67 (8.2%) had PABC. The median age, age range and percentage of patients PABC were 35 years, 20 – 46 years and 56% compared with 49 years, 31 – 79 years and 10% respectively in individuals with Non-PABC. The peak age group for PABC was 35 – 39 while for Non-PABC, it was 45 – 49. A higher proportion of women (32.8%) with PABC presented with a Stage IV disease compared to 23.6% in Non-PABC. BMI > 25 was significantly associated with PABC while hormonal contraceptive use and a family history of breast cancer had marginal associations.

Conclusions: PABC patients had a longer duration of symptoms with a higher proportion of advanced-stage disease at presentation. Counseling and educating patients and health care personnel about the physiological and pathological breast changes in pregnancy and lactation is necessary.