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Bounous VE, Minella C, Fuso L, Actis S, Petroni G, Sgrò LG, Borghese M, Tomasi Cont N, Ponzone R, Ferrero A. Impact of Pregnancy on Breast Cancer Features and Prognosis. Curr Oncol 2024; 31:2305-2315. [PMID: 38668074 PMCID: PMC11049015 DOI: 10.3390/curroncol31040171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND pregnancy-associated breast cancer (PABC) affects one in 3000 pregnancies, often presenting with aggressive features. METHODS We retrospectively evaluated a cohort of 282 young BC patients (≤45 years old) treated between 1995 and 2019, dividing them into three groups: nulliparous women, women with PABC (diagnosed within 2 years since last pregnancy) and women with BC diagnosed > 2 years since last pregnancy. This last group was further stratified according to the time between pregnancy and BC. The analysis encompassed histological factors (tumor size, histotype, grading, nodal involvement, multifocality, lympho-vascular invasion, hormone receptor expression, Ki-67 index, and HER2 expression), type of surgery and recurrence. RESULTS Age at diagnosis was younger in nulliparous than in parous women (p < 0.001). No significant differences were noticed regarding histological characteristics and recurrences. At univariate analysis, nodal involvement (OR = 2.4; p < 0.0001), high tumor grade (OR = 2.6; p = 0.01), and lympho-vascular invasion (OR = 2.3; p < 0.05), but not pregnancy (OR = 0.8; p = 0.30), influenced DFS negatively. Multivariate analysis confirmed nodal involvement as the only negative independent prognostic factor for a worse DFS (OR = 2.4; p = 0.0001). CONCLUSIONS in our experience, pregnancy is not an independent adverse prognostic factor for BC DFS.
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Affiliation(s)
- Valentina E. Bounous
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Carola Minella
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Luca Fuso
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Silvia Actis
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Greta Petroni
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Luca G. Sgrò
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
| | - Martina Borghese
- Department of Gynecology and Obstetrics, Santa Croce and Carle Hospital, 12100 Cuneo, Italy;
| | | | - Riccardo Ponzone
- Gynaecological Department, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142, 10060 Candiolo, Italy;
| | - Annamaria Ferrero
- Gynecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Largo Turati 62, 10128 Turin, Italy; (C.M.); (L.F.); (S.A.); (G.P.); (L.G.S.); (A.F.)
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Patel A, Dewani D, Jaiswal A, Reddy LS, Yadav P, Sethi N. Unveiling the Role of Pregnancy-Associated Plasma Protein A (PAPP-A) in Pregnancy-Associated Breast Cancer: A Comprehensive Review. Cureus 2024; 16:e56269. [PMID: 38623138 PMCID: PMC11017795 DOI: 10.7759/cureus.56269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/16/2024] [Indexed: 04/17/2024] Open
Abstract
Pregnancy-associated breast cancer (PABC) presents unique challenges due to its occurrence during or shortly after pregnancy. Pregnancy-associated plasma protein A (PAPP-A) has emerged as a potential biomarker and regulator in PABC. This comprehensive review examines the role of PAPP-A in PABC, highlighting its involvement in tissue remodeling and cancer progression. Molecular mechanisms linking PAPP-A to breast cancer, including signaling pathways and interactions with other molecules, are explored. The review also discusses the diagnostic and therapeutic implications of PAPP-A dysregulation in PABC, emphasizing the need for further research to elucidate underlying mechanisms and develop targeted therapies. Collaborative efforts among researchers, clinicians, and industry stakeholders are essential for translating findings into clinically relevant interventions to improve outcomes for PABC patients.
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Affiliation(s)
- Archan Patel
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Deepika Dewani
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Arpita Jaiswal
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Lucky Srivani Reddy
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Yadav
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha Sethi
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Sala V, Di Simone G, Lubrano C, Quarenghi A, Rossi RS, Nebuloni M, Cetin I. An uncommon case of metastatic undifferentiated pleomorphic soft tissue sarcoma during pregnancy: Literature review and case report. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100278. [PMID: 38234385 PMCID: PMC10792739 DOI: 10.1016/j.eurox.2023.100278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024] Open
Abstract
Soft tissue sarcomas accounts for 1-2% of adult malignancies. Undifferentiated pleomorphic sarcoma (UPS) is a rare subtype that lack immunohistochemical markers for a specific definition. About 18% of sarcomas are at a locally advanced stage, often requiring several cycles of chemotherapy and radiotherapy, in addition to surgery. For a young woman, this can mean delaying pregnancies with a high risk of therapy-induced ovarian damage. For this reason, proper counseling on fertility preservation plays a key role. In addition, all women of childbearing age with cancer, should be informed about the importance of planning a pregnancy to improve maternal and neonatal outcomes. We report a rare case of a 40-year-old woman with a UPS who, during CT scan after chemotherapy to decide on surgery, find out she was pregnant. After counseling, the patient decides to go ahead with the pregnancy.
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Affiliation(s)
- Valentina Sala
- Unit of Obstetrics and Gynecology, Buzzi Children’s Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20154 Milan, Italy
| | - Giuliana Di Simone
- Unit of Obstetrics and Gynecology, Buzzi Children’s Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20154 Milan, Italy
| | - Chiara Lubrano
- Unit of Obstetrics and Gynecology, Buzzi Children’s Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20154 Milan, Italy
| | - Aida Quarenghi
- Unit of Obstetrics and Gynecology, Buzzi Children’s Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20154 Milan, Italy
| | | | - Manuela Nebuloni
- Pathology Unit, ASST Fatebenefratelli Sacco, Department of Biological and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Irene Cetin
- Unit of Obstetrics and Gynecology, Buzzi Children’s Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20154 Milan, Italy
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Piergentili R, Marinelli E, Cucinella G, Lopez A, Napoletano G, Gullo G, Zaami S. miR-125 in Breast Cancer Etiopathogenesis: An Emerging Role as a Biomarker in Differential Diagnosis, Regenerative Medicine, and the Challenges of Personalized Medicine. Noncoding RNA 2024; 10:16. [PMID: 38525735 PMCID: PMC10961778 DOI: 10.3390/ncrna10020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/10/2024] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
Breast Cancer (BC) is one of the most common cancer types worldwide, and it is characterized by a complex etiopathogenesis, resulting in an equally complex classification of subtypes. MicroRNA (miRNA or miR) are small non-coding RNA molecules that have an essential role in gene expression and are significantly linked to tumor development and angiogenesis in different types of cancer. Recently, complex interactions among coding and non-coding RNA have been elucidated, further shedding light on the complexity of the roles these molecules fulfill in cancer formation. In this context, knowledge about the role of miR in BC has significantly improved, highlighting the deregulation of these molecules as additional factors influencing BC occurrence, development and classification. A considerable number of papers has been published over the past few years regarding the role of miR-125 in human pathology in general and in several types of cancer formation in particular. Interestingly, miR-125 family members have been recently linked to BC formation as well, and complex interactions (competing endogenous RNA networks, or ceRNET) between this molecule and target mRNA have been described. In this review, we summarize the state-of-the-art about research on this topic.
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Affiliation(s)
- Roberto Piergentili
- Institute of Molecular Biology and Pathology, Italian National Research Council (CNR-IBPM), 00185 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 04100 Latina, Italy;
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy; (G.C.); (A.L.); (G.G.)
| | - Alessandra Lopez
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy; (G.C.); (A.L.); (G.G.)
| | - Gabriele Napoletano
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic Medicine, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy; (G.C.); (A.L.); (G.G.)
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic Medicine, “Sapienza” University of Rome, 00161 Rome, Italy;
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Pierannunzio D, Maraschini A, Lopez T, Donati S, Amodio R, Bianconi F, Bruni R, Castaing M, Cirilli C, Fantaci G, Guarda L, Iacovacci S, Mangone L, Mazzoleni G, Mazzucco W, Melcarne A, Merlo E, Parazzini F, Peccatori FA, Rugge M, Sampietro G, Scambia G, Scarfone G, Sferrazza A, Stracci F, Torrisi A, Vitale MF, Francisci S. Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database. Cancers (Basel) 2023; 15:4305. [PMID: 37686581 PMCID: PMC10486505 DOI: 10.3390/cancers15174305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this study is to describe the frequency and trend of pregnancy-associated cancer (PAC) in Italy, an increasingly relevant phenomenon due to postponing age at childbirth. To this purpose, a population-based retrospective longitudinal study design based on cohorts of women aged 15-49 diagnosed with cancer and concomitant pregnancy is proposed. The study uses 19 population-based Cancer Registries, covering about 22% of Italy, and linked at an individual level with Hospital Discharge Records. A total of 2,861,437 pregnancies and 3559 PAC are identified from 74,165 women of the cohort with a rate of 1.24 PAC per 1000 pregnancies. The most frequent cancer site is breast (24.3%), followed by thyroid (23.9%) and melanoma (14.3%). The most frequent outcome is delivery (53.1%), followed by voluntary termination of pregnancy and spontaneous abortion (both 12.0%). The trend of PAC increased from 2003 to 2015, especially when the outcome is delivery, thus confirming a new attitude of clinicians to manage cancer throughout pregnancy. This represents the first attempt in Italy to describe PAC from Cancer Registries data; the methodology is applicable to other areas with the same data availability. Evidence from this study is addressed to clinicians for improving clinical management of women with PAC.
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Affiliation(s)
- Daniela Pierannunzio
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Alice Maraschini
- Technical-Scientific Statistical Service, Italian National Institute of Health, 00162 Rome, Italy
| | - Tania Lopez
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Rosalba Amodio
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP), 90127 Palermo, Italy
| | | | | | - Marine Castaing
- Siracusa Cancer Registry, Health Unit of Siracusa, 96100 Siracusa, Italy
| | - Claudia Cirilli
- Dipartimento di Epidemiologia e Comunicazione del Rischio, AUSL di Modena, 41126 Modena, Italy
| | | | - Linda Guarda
- SC Osservatorio Epidemiologico ATS Valpadana, 46100 Mantova, Italy
| | - Silvia Iacovacci
- RT LT, Dipartimento di Prevenzione ASL Latina, 04100 Latina, Italy
| | - Lucia Mangone
- European Epidemiology Unit, Gynecologic Oncology Department, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | | | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP), 90127 Palermo, Italy
| | | | - Elisabetta Merlo
- UOC Epidemiologia, Agenzia per la Tutela della Salute (ATS) della Brianza, 20900 Monza, Italy
| | - Fabio Parazzini
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122 Milano, Italy
| | | | - Massimo Rugge
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy
- Veneto Tumor Registry (RTV), Veneto Regional Authority, 35132 Padova, Italy
| | | | - Giovanni Scambia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica Roma, 00168 Roma, Italy
| | - Giovanna Scarfone
- Gynecologic Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Ausilia Sferrazza
- ASP Ragusa-Dipartimento Medico di Prevenzione, UOSD Registro Tumori, 97100 Ragusa, Italy
| | - Fabrizio Stracci
- Associazione Nazionale dei Registri Tumori—AIRTUM—Public Health Section, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Antonina Torrisi
- Registro Tumori Integrato, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico—San Marco”, 95123 Catania, Italy
| | | | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
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