Citation
Vohra, Sanah N.; Walens, Andrea; Hamilton, Alina M.; Sherman, Mark E.; Schedin, Pepper J.; Nichols, Hazel B.; Reeder-Hayes, Katherine E.; Olshan, Andrew F.; Love, Michael I.; & Troester, Melissa A. (2022). Molecular and Clinical Characterization of Postpartum-Associated Breast Cancer in the Carolina Breast Cancer Study Phase I-III, 1993-2013. Cancer Epidemiology, Biomarkers & Prevention, 31(3), 561-568. PMCID: PMC8901538Abstract
BACKGROUND: Breast cancers in recently postpartum women may have worse outcomes, but studies examining tumor molecular features by pregnancy recency have shown conflicting results.METHODS: This analysis used Carolina Breast Cancer Study data to examine clinical and molecular tumor features among women <50 years of age who were recently ( {less than or equal to} 10 years prior), or remotely (>10 years prior) postpartum, or nulliparous. Prevalence odds ratios (PORs) and 95% confidence intervals (CIs) were estimated using multivariable models.
RESULTS: Recently postpartum women (N=618) were more frequently lymph node positive [POR (95% CI): 1.66 (1.26, 2.19)], ER negative [1.37 (1.02, 1.83)], and IHC-based triple negative [1.57 (1.00, 2.47)] compared to nulliparous (N=360) women. Some differences were identified between recent vs. remotely postpartum; smaller tumor size [0.67 (0.52, 0.86)], p53 wildtype [0.53 (0.36, 0.77)], and non-basal-like phenotype [0.53 (0.33, 0.84)] were more common among recently postpartum. Recently postpartum (vs. nulliparous) had significant enrichment for adaptive immunity, T cells, B cells, CD8 T cells, activated CD8 T cells/NK cells, Tfh cells and higher overall immune cell scores. These differences were attenuated in remotely (compared to recently) postpartum women.
CONCLUSIONS: These results suggest a dominant effect of parity (vs. nulliparity) and a lesser effect of pregnancy recency on tumor molecular features, although tumor immune microenvironments were altered in association with pregnancy recency.
IMPACT: Our study is unique in examining tumor immune microenvironment and RNA-based markers according to time since last childbirth. Future studies should examine the interplay between tumor features, post-diagnostic treatment and outcomes among recently postpartum women.
URL
http://dx.doi.org/10.1158/1055-9965.EPI-21-0940Reference Type
Journal ArticleYear Published
2022Journal Title
Cancer Epidemiology, Biomarkers & PreventionAuthor(s)
Vohra, Sanah N.Walens, Andrea
Hamilton, Alina M.
Sherman, Mark E.
Schedin, Pepper J.
Nichols, Hazel B.
Reeder-Hayes, Katherine E.
Olshan, Andrew F.
Love, Michael I.
Troester, Melissa A.