Pregnancy-associated breast cancer is as chemosensitive as non-pregnancy-associated breast cancer in the neoadjuvant setting.
BACKGROUND
The aim of this study was to determine the chemosensitivity of pregnancy-associated breast cancer (PABC) in the neoadjuvant setting by comparing the observed pathological complete response (pCR) rate with the rate predicted by a validated nomogram.


METHODS
Data from 48 PABC patients who received neoadjuvant chemotherapy (NACT) were collected. To predict the response rate to chemotherapy, we used well-calibrated logistic regression-based nomograms to calculate individual probability of pCR.


RESULTS
Observed rates of pCR were concordant with predictions in the whole sample and in the analyzed subgroups. For the whole sample, the area under the receiver-operated curve (AUC) was 0.77 (95% CI 0.66-0.87). The calibration of predicted and observed probabilities was excellent. In the subgroup analyses (NACT initiated during pregnancy or postpartum, NACT with only anthracycline or both anthracycline and taxanes), discriminations assessed by AUC were significantly above 0.5, except for patients treated with anthracycline only. The interpretation was limited by a lack of power.


CONCLUSIONS
Through the use of nomograms, our study demonstrates that PABC is as chemosensitive as non-PABC and suggests that taxanes should be part of the NACT regimen for PABC. Further studies are warranted to increase the power of the presented data.
CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP). Electronic address: roman.rouzier@tnn.aphp.fr.
R
R
Rouzier
Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP).
G
G
Werkoff
CALG (Cancers Associés à La Grossesse) Network; Department of Surgical Oncology; Breast Cancer Unit, Institut Gustave Roussy, University Paris 11.
C
C
Uzan
CALG (Cancers Associés à La Grossesse) Network; Department of Pharmacology; Department of Medical Oncology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris; University Paris Descartes, Paris 5.
O
O
Mir
CALG (Cancers Associés à La Grossesse) Network; Medical Oncology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris.
J
J
Gligorov
CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris.
L
L
Selleret
CALG (Cancers Associés à La Grossesse) Network; University Paris Descartes, Paris 5; Obstetrics and Gynecology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Paris, France.
F
F
Goffinet
Department of Medical Oncology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris; University Paris Descartes, Paris 5.
F
F
Goldwasser
CALG (Cancers Associés à La Grossesse) Network; Department of Pharmacology; University Paris Descartes, Paris 5.
J M
JM
Treluyer
CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP).
S
S
Uzan
CALG (Cancers Associés à La Grossesse) Network; Department of Surgical Oncology; Breast Cancer Unit, Institut Gustave Roussy, University Paris 11.
S
S
Delaloge
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020360:Neoadjuvant Therapy; D049451:Nomograms; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents