title: Does pregnancy-associated breast cancer imply a worse prognosis? A matched case-case study.
abstract: BACKGROUND
  Significant controversy exists in the literature regarding the role of pregnancy in the prognosis of breast cancer. We designed a matched case-case study, matching pregnancy-associated breast cancer (PABC) cases with breast cancer cases for stage, age, and year of diagnosis.
  
  
  METHODS
  39 consecutive cases of PABC were matched with 39 premenopausal cases of breast cancer. Univariate and multivariate survival analyses followed by adjustment for stage, grade, estrogen receptor status, and age at diagnosis, were performed.
  
  
  RESULTS
  Regarding overall survival (OS), univariate analysis pointed to longer OS in non-PABC cases vs. PABC cases. Accordingly, a more advanced stage predicted shorter survival. In the multivariate analysis, the independent aggravating effect mediated by pregnancy persisted. Interestingly, a post hoc nested analysis within PABC cases indicated that the 3rd trimester pointed to shorter OS. The aforementioned results on OS were also replicated during the examination of relapse-free survival.
  
  
  CONCLUSIONS
  Implementing a matched case-case design, the present study points to pregnancy as a poor prognostic factor for breast cancer.
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Constantine
authors.initials: C
authors.lastname: Dimitrakakis
authors.affiliation: Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece.
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Tsigginou
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Spyros
authors.initials: S
authors.lastname: Marinopoulos
authors.affiliation: 1st Propaedeutic Surgical Department, Hippocrateio Hospital, University of Athens, Greece.
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Antonis
authors.initials: A
authors.lastname: Keramopoulos
authors.affiliation: 1st Propaedeutic Surgical Department, Hippocrateio Hospital, University of Athens, Greece.
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Ampela
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Mpaltas
authors.affiliation: Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Papadimitriou
authors.affiliation: Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece.
authors.forename: Meletios-Athanassios
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: Department of Obstetrics and Gynecology Alexandra Hospital, University of Athens, Greece.
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
keywords: Breast cancer; Pregnancy; Prognosis; Survival