Skip to main content

Advertisement

SpringerLink
Log in

Pregnancy-associated breast cancer: the risky status quo and new concepts of predictive medicine

  • Review
  • Published:
EPMA Journal Aims and scope Submit manuscript

Abstract

The paper is motivated by severe concerns regarding currently applied care of the pregnancy-associated breast cancer (PABC) characterised by particularly poor outcomes of the disease. Psychological and ethical aspects play a crucial role in PABC: the highest priority not to damage the foetus significantly complicates any treatment generally, and it is quite usual that patients disclaim undergoing any breast cancer treatment during pregnancy. Although, due to global demographic trends, PABC is far from appearing rarely now, severe societal and economic consequences of the disease are still neglected by currently applied reactive medical approach. These actualities require creating new strategies which should be better adapted to the needs of the society at large by advancing the PABC care based on predictive diagnostic approaches specifically in premenopausal women, innovative screening programmes focused on young female populations, targeted prevention in high-risk groups, and optimised treatment concepts. The article summarises the facts and provides recommendations to advance the field-related research and medical services specifically dedicated to the PABC care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. White TT. Carcinoma of the breast and pregnancy; analysis of 920 cases collected from the literature and 22 new cases. Ann Surg. 1954;139(1):9–18. https://doi.org/10.1097/00000658-195401000-00002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Golubnitschaja O, Debald M, Yeghiazaryan K, Kuhn W, Pešta M, Costigliola V, et al. Breast cancer epidemic in the early twenty-first century: evaluation of risk factors, cumulative questionnaires and recommendations for preventive measures. Tumour Biol. 2016;37(10):12941–57. https://doi.org/10.1007/s13277-016-5168-x.

    Article  PubMed  Google Scholar 

  3. Rodriguez AO, Chew H, Cress R, Xing G, McElvy S, Danielsen B, et al. Evidence of poorer survival in pregnancy-associated breast cancer. Obstet Gynecol. 2008;112(1):71–8. https://doi.org/10.1097/AOG.0b013e31817c4ebc.

    Article  PubMed  Google Scholar 

  4. Kim YG, Jeon YW, Ko BK, Sohn G, Kim E-K, Moon B-I, et al. Clinicopathologic characteristics of pregnancy-associated breast cancer: results of analysis of a nationwide breast cancer registry database. J Breast Cancer. 2017;20(3):264–9. https://doi.org/10.4048/jbc.2017.20.3.264.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Langer A, Mohallem M, Stevens D, Rouzier R, Lerebours F, Chérel P. A single-institution study of 117 pregnancy-associated breast cancers (PABC): presentation, imaging, clinicopathological data and outcome. Diagn Interv Imaging. 2014;95(4):435–41. https://doi.org/10.1016/j.diii.2013.12.021.

    Article  CAS  PubMed  Google Scholar 

  6. Sánchez C, Acevedo F, Medina L, Ibáñez C, Razmilic D, Elena Navarro M, et al. Breast cancer and pregnancy: a comparative analysis of a Chilean cohort. Ecancermedicalscience. 2014;8:434.

    PubMed  PubMed Central  Google Scholar 

  7. Shachar SS, Gallagher K, McGuire K, Zagar TM, Faso A, Muss HB, et al. Multidisciplinary management of breast cancer during pregnancy. Oncologist. 2017;22(3):324–34. https://doi.org/10.1634/theoncologist.2016-0208.

    Article  PubMed  Google Scholar 

  8. Zagouri F, Psaltopoulou T, Dimitrakakis C, Bartsch R, Dimopoulos M-A. Challenges in managing breast cancer during pregnancy. J Thorac Dis. 2013;5(Suppl 1):S62–7.

    PubMed  PubMed Central  Google Scholar 

  9. Loibl S, Han SN, von Minckwitz G, Bontenbal M, Ring A, Giermek J, et al. Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol. 2012;13(9):887–96. https://doi.org/10.1016/S1470-2045(12)70261-9.

    Article  CAS  PubMed  Google Scholar 

  10. Moreira WB, Brandão EC, Soares AN, de Lucena CEM, Antunes CMF. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study. Sao Paulo Med J Rev Paul Med. 2010;128(3):119–24. https://doi.org/10.1590/S1516-31802010000300003.

    Article  Google Scholar 

  11. American College of Pediatrics - December 2013. Information for the adolescent woman and her parents: abortion and the risk of breast cancer. Issues Law Med. 2017;32:99–104.

    Google Scholar 

  12. Hou N, Ogundiran T, Ojengbede O, Morhason-Bello I, Zheng Y, Fackenthal J, et al. Risk factors for pregnancy-associated breast cancer: a report from the Nigerian Breast Cancer Study. Ann Epidemiol. 2013;23(9):551–7. https://doi.org/10.1016/j.annepidem.2013.06.008.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Molckovsky A, Madarnas Y. Breast cancer in pregnancy: a literature review. Breast Cancer Res Treat. 2008;108(3):333–8. https://doi.org/10.1007/s10549-007-9616-6.

    Article  PubMed  Google Scholar 

  14. White TT. Carcinoma of the breast in the pregnant and the nursing patient; review of 1,375 cases. Am J Obstet Gynecol. 1955;69(6):1277–86. https://doi.org/10.1016/S0002-9378(16)38162-5.

    Article  CAS  PubMed  Google Scholar 

  15. Amant F, Loibl S, Neven P, Van Calsteren K. Breast cancer in pregnancy. Lancet. 2012;379(9815):570–9. https://doi.org/10.1016/S0140-6736(11)61092-1.

    Article  PubMed  Google Scholar 

  16. Ruiz R, Herrero C, Strasser-Weippl K, Touya D, St Louis J, Bukowski A, et al. Epidemiology and pathophysiology of pregnancy-associated breast cancer: a review. Breast. 2017;35:136–41. https://doi.org/10.1016/j.breast.2017.07.008.

    Article  PubMed  Google Scholar 

  17. Johansson ALV, Andersson TM-L, Hsieh C-C, Jirström K, Dickman P, Cnattingius S, et al. Stage at diagnosis and mortality in women with pregnancy-associated breast cancer (PABC). Breast Cancer Res Treat. 2013;139(1):183–92. https://doi.org/10.1007/s10549-013-2522-1.

    Article  PubMed  Google Scholar 

  18. Callihan EB, Gao D, Jindal S, Lyons TR, Manthey E, Edgerton S, et al. Postpartum diagnosis demonstrates a high risk for metastasis and merits an expanded definition of pregnancy-associated breast cancer. Breast Cancer Res Treat. 2013;138(2):549–59. https://doi.org/10.1007/s10549-013-2437-x.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Schedin P. Pregnancy-associated breast cancer and metastasis. Nat Rev Cancer. 2006;6(4):281–91. https://doi.org/10.1038/nrc1839.

    Article  CAS  PubMed  Google Scholar 

  20. Pentheroudakis G, Orecchia R, Hoekstra HJ, Pavlidis N, ESMO Guidelines Working Group. Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl 5):v266–73. https://doi.org/10.1093/annonc/mdq198.

    Article  PubMed  Google Scholar 

  21. Kakoulidis I, Skagias L, Politi E. Pregnancy associated breast cancer (PABC): aspects in diagnosis. Breast Dis. 2015;35(3):157–66. https://doi.org/10.3233/BD-150408.

    Article  CAS  PubMed  Google Scholar 

  22. Andersson TM-L, Johansson ALV, Hsieh C-C, Cnattingius S, Lambe M. Increasing incidence of pregnancy-associated breast cancer in Sweden. Obstet Gynecol. 2009;114(3):568–72. https://doi.org/10.1097/AOG.0b013e3181b19154.

    Article  PubMed  Google Scholar 

  23. Keyser EA, Staat BC, Fausett MB, Shields AD. Pregnancy-associated breast cancer. Rev Obstet Gynecol. 2012;5(2):94–9.

    PubMed  PubMed Central  Google Scholar 

  24. Beadle BM, Woodward WA, Middleton LP, Tereffe W, Strom EA, Litton JK, et al. The impact of pregnancy on breast cancer outcomes in women<or=35 years. Cancer. 2009;115(6):1174–84. https://doi.org/10.1002/cncr.24165.

    Article  PubMed  PubMed Central  Google Scholar 

  25. | Human Development Reports [Internet]. [cited 2018 Jan 2]. Available from: http://hdr.undp.org/en/2016-report.

  26. Lyons TR, Schedin PJ, Borges VF. Pregnancy and breast cancer: when they collide. J Mammary Gland Biol Neoplasia. 2009;14(2):87–98. https://doi.org/10.1007/s10911-009-9119-7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Yager JD, Davidson NE. Estrogen carcinogenesis in breast cancer. N Engl J Med. 2006;354(3):270–82. https://doi.org/10.1056/NEJMra050776.

    Article  CAS  PubMed  Google Scholar 

  28. Germain D. Estrogen carcinogenesis in breast cancer. Endocrinol Metab Clin N Am. 2011;40(3):473–84, vii. https://doi.org/10.1016/j.ecl.2011.05.009.

    Article  CAS  Google Scholar 

  29. Lanzino M, Morelli C, Garofalo C, Panno ML, Mauro L, Andò S, et al. Interaction between estrogen receptor alpha and insulin/IGF signaling in breast cancer. Curr Cancer Drug Targets. 2008;8(7):597–610. https://doi.org/10.2174/156800908786241104.

    Article  CAS  PubMed  Google Scholar 

  30. Gupta PB, Proia D, Cingoz O, Weremowicz J, Naber SP, Weinberg RA, et al. Systemic stromal effects of estrogen promote the growth of estrogen receptor-negative cancers. Cancer Res. 2007;67(5):2062–71. https://doi.org/10.1158/0008-5472.CAN-06-3895.

    Article  CAS  PubMed  Google Scholar 

  31. Shakhar K, Valdimarsdottir HB, Bovbjerg DH. Heightened risk of breast cancer following pregnancy: could lasting systemic immune alterations contribute? Cancer Epidemiol Biomark Prev. 2007;16(6):1082–6. https://doi.org/10.1158/1055-9965.EPI-07-0014.

    Article  CAS  Google Scholar 

  32. Graham C, Chooniedass R, Stefura WP, Becker AB, Sears MR, Turvey SE, et al. In vivo immune signatures of healthy human pregnancy: inherently inflammatory or anti-inflammatory? PLoS One. 2017;12(6):e0177813. https://doi.org/10.1371/journal.pone.0177813.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Aagaard-Tillery KM, Silver R, Dalton J. Immunology of normal pregnancy. Semin Fetal Neonatal Med. 2006;11(5):279–95. https://doi.org/10.1016/j.siny.2006.04.003.

    Article  PubMed  Google Scholar 

  34. Rapacz-Leonard A, Dąbrowska M, Janowski T. Major histocompatibility complex I mediates immunological tolerance of the trophoblast during pregnancy and may mediate rejection during parturition. Mediat Inflamm. 2014;2014:579279.

    Google Scholar 

  35. O’Brien J, Lyons T, Monks J, Lucia MS, Wilson RS, Hines L, et al. Alternatively activated macrophages and collagen remodeling characterize the postpartum involuting mammary gland across species. Am J Pathol. 2010;176(3):1241–55. https://doi.org/10.2353/ajpath.2010.090735.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Strange R, Li F, Saurer S, Burkhardt A, Friis RR. Apoptotic cell death and tissue remodelling during mouse mammary gland involution. Dev Camb Engl. 1992;115:49–58.

    CAS  Google Scholar 

  37. Strange R, Metcalfe T, Thackray L, Dang M. Apoptosis in normal and neoplastic mammary gland development. Microsc Res Tech. 2001;52(2):171–81. https://doi.org/10.1002/1097-0029(20010115)52:2<171::AID-JEMT1003>3.0.CO;2-T.

    Article  CAS  PubMed  Google Scholar 

  38. Watson CJ, Kreuzaler PA. Remodeling mechanisms of the mammary gland during involution. Int J Dev Biol. 2011;55(7-8-9):757–62. https://doi.org/10.1387/ijdb.113414cw.

    Article  PubMed  Google Scholar 

  39. Martinson HA, Jindal S, Durand-Rougely C, Borges VF, Schedin P. Wound healing-like immune program facilitates postpartum mammary gland involution and tumor progression. Int J Cancer. 2015;136(8):1803–13. https://doi.org/10.1002/ijc.29181.

    Article  CAS  PubMed  Google Scholar 

  40. Guo Q, Minnier J, Burchard J, Chiotti K, Spellman P, Schedin P. Physiologically activated mammary fibroblasts promote postpartum mammary cancer. JCI Insight. 2017;2:e89206.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Avishai E, Yeghiazaryan K, Golubnitschaja O. Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine. EPMA J. 2017;8(1):23–33. https://doi.org/10.1007/s13167-017-0081-y.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Stolzenburg-Veeser L, Golubnitschaja O. Mini-encyclopaedia of the wound healing—opportunities for integrating multi-omic approaches into medical practice. J Proteomics. 2018. https://doi.org/10.1016/j.jprot.2017.07.017.

  43. Lenhard MS, Bauerfeind I, Untch M. Breast cancer and pregnancy: challenges of chemotherapy. Crit Rev Oncol Hematol. 2008;67(3):196–203. https://doi.org/10.1016/j.critrevonc.2008.02.007.

    Article  PubMed  Google Scholar 

  44. Rovera F, Chiappa C, Coglitore A, Baratelli GM, Fachinetti A, Marelli M, et al. Management of breast cancer during pregnancy. Int J Surg. 2013;11(Suppl 1):S64–8. https://doi.org/10.1016/S1743-9191(13)60020-5.

    Article  PubMed  Google Scholar 

  45. Murphy CG, Mallam D, Stein S, Patil S, Howard J, Sklarin N, et al. Current or recent pregnancy is associated with adverse pathologic features but not impaired survival in early breast cancer. Cancer. 2012;118(13):3254–9. https://doi.org/10.1002/cncr.26654.

    Article  PubMed  Google Scholar 

  46. Stensheim H, Møller B, van Dijk T, Fosså SD. Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol. 2009;27(1):45–51. https://doi.org/10.1200/JCO.2008.17.4110.

    Article  PubMed  Google Scholar 

  47. Basaran D, Turgal M, Beksac K, Ozyuncu O, Aran O, Beksac MS. Pregnancy-associated breast cancer: clinicopathological characteristics of 20 cases with a focus on identifiable causes of diagnostic delay. Breast Care. 2014;9:355–9.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Faguy K. Breast disorders in pregnant and lactating women. Radiol Technol. 2015;86:419M–38M. quiz 439M–442M

    PubMed  Google Scholar 

  49. Taylor D, Lazberger J, Ives A, Wylie E, Saunders C. Reducing delay in the diagnosis of pregnancy-associated breast cancer: how imaging can help us. J Med Imaging Radiat Oncol. 2011;55(1):33–42. https://doi.org/10.1111/j.1754-9485.2010.02227.x.

    Article  PubMed  Google Scholar 

  50. Aziz S, Pervez S, Khan S, Siddiqui T, Kayani N, Israr M, et al. Case control study of novel prognostic markers and disease outcome in pregnancy/lactation-associated breast carcinoma. Pathol Res Pract. 2003;199(1):15–21. https://doi.org/10.1078/0344-0338-00347.

    Article  PubMed  Google Scholar 

  51. Dolle JM, Daling JR, White E, Brinton LA, Doody DR, Porter PL, et al. Risk factors for triple-negative breast cancer in women under the age of 45 years. Cancer Epidemiol Biomarkers Prev. 2009;18:1157–66.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Bonnier P, Romain S, Dilhuydy JM, Bonichon F, Julien JP, Charpin C, et al. Influence of pregnancy on the outcome of breast cancer: a case-control study. Societe Francaise de Senologie et de Pathologie Mammaire Study Group. Int J Cancer. 1997;72(5):720–7. https://doi.org/10.1002/(SICI)1097-0215(19970904)72:5<720::AID-IJC3>3.0.CO;2-U.

    Article  CAS  PubMed  Google Scholar 

  53. Ishida T, Yokoe T, Kasumi F, Sakamoto G, Makita M, Tominaga T, et al. Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation: analysis of case-control study in Japan. Jpn J Cancer Res Gann. 1992;83(11):1143–9. https://doi.org/10.1111/j.1349-7006.1992.tb02737.x.

    Article  CAS  PubMed  Google Scholar 

  54. Strasser-Weippl K, Ramchandani R, Fan L, Li J, Hurlbert M, Finkelstein D, et al. Pregnancy-associated breast cancer in women from Shanghai: risk and prognosis. Breast Cancer Res Treat. 2015;149(1):255–61. https://doi.org/10.1007/s10549-014-3219-9.

    Article  PubMed  Google Scholar 

  55. Mielke S, Meden H, Kuhn W. Expression of the c-erbB-2-encoded oncoprotein p185 (HER-2/neu) in pregnancy as a model for oncogene-induced carcinogenesis. Med Hypotheses. 1998;50(5):359–62. https://doi.org/10.1016/S0306-9877(98)90205-5.

    Article  CAS  PubMed  Google Scholar 

  56. Hsiao Y-H, Su YA, Tsai H-D, Mason JT, Chou M-C, Man Y. Increased invasiveness and aggressiveness in breast epithelia with cytoplasmic p63 expression. Int J Biol Sci. 2010;6(5):428–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Asztalos S, Pham TN, Gann PH, Hayes MK, Deaton R, Wiley EL, et al. High incidence of triple negative breast cancers following pregnancy and an associated gene expression signature. Springerplus. 2015;4(1):710. https://doi.org/10.1186/s40064-015-1512-7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Johannsson O, Loman N, Borg A, Olsson H. Pregnancy-associated breast cancer in BRCA1 and BRCA2 germline mutation carriers. Lancet. 1998;352(9137):1359–60. https://doi.org/10.1016/S0140-6736(05)60750-7.

    Article  CAS  PubMed  Google Scholar 

  59. Robertson C, Primic-Zakelj M, Boyle P, Hsieh CC. Effect of parity and age at delivery on breast cancer risk in Slovenian women aged 25-54 years. Int J Cancer. 1997;73(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  60. Trichopoulos D, Hsieh CC, MacMahon B, Lin TM, Lowe CR, Mirra AP, et al. Age at any birth and breast cancer risk. Int J Cancer. 1983;31(6):701–4. https://doi.org/10.1002/ijc.2910310604.

    Article  CAS  PubMed  Google Scholar 

  61. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360:187–95.

    Article  Google Scholar 

  62. Chowdhury R, Sinha B, Sankar MJ, Taneja S, Bhandari N, Rollins N, et al. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr. 2015;104:96–113.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Hadjisavvas A, Loizidou MA, Middleton N, Michael T, Papachristoforou R, Kakouri E, et al. An investigation of breast cancer risk factors in Cyprus: a case control study. BMC Cancer. 2010;10(1):447. https://doi.org/10.1186/1471-2407-10-447.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Johansson ALV, Andersson TM-L, Hsieh C-C, Cnattingius S, Dickman PW, Lambe M. Family history and risk of pregnancy-associated breast cancer (PABC). Breast Cancer Res Treat. 2015;151(1):209–17. https://doi.org/10.1007/s10549-015-3369-4.

    Article  CAS  PubMed  Google Scholar 

  65. Pollán M. Epidemiology of breast cancer in young women. Breast Cancer Res Treat. 2010;123(Suppl 1):3–6. https://doi.org/10.1007/s10549-010-1098-2.

    Article  PubMed  Google Scholar 

  66. Rousset-Jablonski C, Gompel A. Screening for familial cancer risk: focus on breast cancer. Maturitas. 2017;105:69–77. https://doi.org/10.1016/j.maturitas.2017.08.004.

    Article  PubMed  Google Scholar 

  67. Yu JH, Kim MJ, Cho H, Liu HJ, Han S-J, Ahn T-G. Breast diseases during pregnancy and lactation. Obstet Gynecol Sci. 2013;56(3):143–59. https://doi.org/10.5468/ogs.2013.56.3.143.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Albrektsen G, Heuch I, Hansen S, Kvåle G. Breast cancer risk by age at birth, time since birth and time intervals between births: exploring interaction effects. Br J Cancer. 2005;92(1):167–75. https://doi.org/10.1038/sj.bjc.6602302.

    Article  CAS  PubMed  Google Scholar 

  69. Colditz GA, Frazier AL. Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focus. Cancer Epidemiol Biomarkers Prev. 1995;4:567–71.

    CAS  PubMed  Google Scholar 

  70. Warren Andersen S, Trentham-Dietz A, Gangnon RE, Hampton JM, Figueroa JD, Skinner HG, et al. Reproductive windows, genetic loci, and breast cancer risk. Ann Epidemiol. 2014;24(5):376–82. https://doi.org/10.1016/j.annepidem.2014.02.007.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Gaudet MM, Press MF, Haile RW, Lynch CF, Glaser SL, Schildkraut J, et al. Risk factors by molecular subtypes of breast cancer across a population-based study of women 56 years or younger. Breast Cancer Res Treat. 2011;130(2):587–97. https://doi.org/10.1007/s10549-011-1616-x.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Millikan RC, Newman B, Tse C-K, Moorman PG, Conway K, Dressler LG, et al. Epidemiology of basal-like breast cancer. Breast Cancer Res Treat. 2008;109(1):123–39. https://doi.org/10.1007/s10549-007-9632-6.

    Article  PubMed  Google Scholar 

  73. Simmen FA, Simmen RCM. The maternal womb: a novel target for cancer prevention in the era of the obesity pandemic? Eur J Cancer Prev. 2011;20(6):539–48. https://doi.org/10.1097/CEJ.0b013e328348fc21.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Polivka J, Kralickova M, Polivka J, Kaiser C, Kuhn W, Golubnitschaja O. Mystery of the brain metastatic disease in breast cancer patients: improved patient stratification, disease prediction and targeted prevention on the horizon? EPMA J. 2017;8(2):119–27. https://doi.org/10.1007/s13167-017-0087-5.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2017;68(1):31–54. https://doi.org/10.3322/caac.21440.

    Article  PubMed  Google Scholar 

  76. Catsburg C, Miller AB, Rohan TE. Active cigarette smoking and risk of breast cancer. Int J Cancer. 2015;136(9):2204–9. https://doi.org/10.1002/ijc.29266.

    Article  CAS  PubMed  Google Scholar 

  77. White AJ, Bradshaw PT, Herring AH, Teitelbaum SL, Beyea J, Stellman SD, et al. Exposure to multiple sources of polycyclic aromatic hydrocarbons and breast cancer incidence. Environ Int. 2016;89–90:185–92.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  78. Liu Y, Colditz GA, Rosner B, Berkey CS, Collins LC, Schnitt SJ, et al. Alcohol intake between menarche and first pregnancy: a prospective study of breast cancer risk. J Natl Cancer Inst. 2013;105(20):1571–8. https://doi.org/10.1093/jnci/djt213.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Schottenfeld D, Jr JFF, editors. Cancer epidemiology and prevention. Third edition. Oxford: Oxford University Press; 2006. https://doi.org/10.1093/acprof:oso/9780195149616.001.0001.

    Google Scholar 

  80. Richter K, Acker J, Kamcev N, Bajraktarov S, Piehl A, Niklewski G. Recommendations for the prevention of breast cancer in shift workers. EPMA J. 2011;2(4):351–6. https://doi.org/10.1007/s13167-011-0126-6.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Blakeman V, Williams JL, Meng Q-J, Streuli CH. Circadian clocks and breast cancer. Breast Cancer Res. 2016;18(1):89. https://doi.org/10.1186/s13058-016-0743-z.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Fritschi L, Glass DC, Heyworth JS, Aronson K, Girschik J, Boyle T, et al. Hypotheses for mechanisms linking shiftwork and cancer. Med Hypotheses. 2011;77(3):430–6. https://doi.org/10.1016/j.mehy.2011.06.002.

    Article  CAS  PubMed  Google Scholar 

  83. Megdal SP, Kroenke CH, Laden F, Pukkala E, Schernhammer ES. Night work and breast cancer risk: a systematic review and meta-analysis. Eur J Cancer. 2005;41:2023–32.

    Article  PubMed  Google Scholar 

  84. Wegrzyn LR, Tamimi RM, Rosner BA, Brown SB, Stevens RG, Eliassen AH, et al. Rotating night-shift work and the risk of breast cancer in the nurses’ health studies. Am J Epidemiol. 2017;186(5):532–40. https://doi.org/10.1093/aje/kwx140.

    Article  PubMed  Google Scholar 

  85. Rafnsson V, Tulinius H, Jónasson JG, Hrafnkelsson J. Risk of breast cancer in female flight attendants: a population-based study (Iceland). Cancer Causes Control. 2001;12(2):95–101. https://doi.org/10.1023/A:1008983416836.

    Article  CAS  PubMed  Google Scholar 

  86. Linnersjö A, Hammar N, Dammström B-G, Johansson M, Eliasch H. Cancer incidence in airline cabin crew: experience from Sweden. Occup Environ Med. 2003;60(11):810–4. https://doi.org/10.1136/oem.60.11.810.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Pukkala E, Auvinen A, Wahlberg G. Incidence of cancer among Finnish airline cabin attendants, 1967-92. BMJ. 1995;311(7006):649–52. https://doi.org/10.1136/bmj.311.7006.649.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901–14. https://doi.org/10.1093/annonc/mdu042.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Hardefeldt PJ, Edirimanne S, Eslick GD. Diabetes increases the risk of breast cancer: a meta-analysis. Endocr Relat Cancer. 2012;19(6):793–803. https://doi.org/10.1530/ERC-12-0242.

    Article  PubMed  Google Scholar 

  90. Boyle P, Boniol M, Koechlin A, Robertson C, Valentini F, Coppens K, et al. Diabetes and breast cancer risk: a meta-analysis. Br J Cancer. 2012;107(9):1608–17. https://doi.org/10.1038/bjc.2012.414.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Park Y-MM, O’Brien KM, Zhao S, Weinberg CR, Baird DD, Sandler DP. Gestational diabetes mellitus may be associated with increased risk of breast cancer. Br J Cancer. 2017;116(7):960–3. https://doi.org/10.1038/bjc.2017.34.

    Article  CAS  PubMed  Google Scholar 

  92. Zubor P, Gondova A, Polivka J, Kasajova P, Konieczka K, Danko J, et al. Breast cancer and Flammer syndrome: any symptoms in common for prediction, prevention and personalised medical approach? EPMA J. 2017;8(2):129–40. https://doi.org/10.1007/s13167-017-0089-3.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Bubnov R, Polivka J, Zubor P, Konieczka K, Golubnitschaja O. “Pre-metastatic niches” in breast cancer: are they created by or prior to the tumour onset? “Flammer syndrome” relevance to address the question. EPMA J. 2017;8(2):141–57. https://doi.org/10.1007/s13167-017-0092-8.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Smokovski I, Risteski M, Polivka J, Zubor P, Konieczka K, Costigliola V, et al. Postmenopausal breast cancer: European challenge and innovative concepts. EPMA J. 2017;8(2):159–69. https://doi.org/10.1007/s13167-017-0094-6.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K, Morris J, et al. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study. BJOG. 2012;119(13):1572–82. https://doi.org/10.1111/j.1471-0528.2012.03475.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Ballard-Barbash R, Hunsberger S, Alciati MH, Blair SN, Goodwin PJ, McTiernan A, et al. Physical activity, weight control, and breast cancer risk and survival: clinical trial rationale and design considerations. J Natl Cancer Inst. 2009;101(9):630–43. https://doi.org/10.1093/jnci/djp068.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Bernstein L. Exercise and breast cancer prevention. Curr Oncol Rep. 2009;11(6):490–6. https://doi.org/10.1007/s11912-009-0066-7.

    Article  PubMed  Google Scholar 

  98. Zeng H, Irwin ML, Lu L, Risch H, Mayne S, Mu L, et al. Physical activity and breast cancer survival: an epigenetic link through reduced methylation of a tumor suppressor gene L3MBTL1. Breast Cancer Res Treat. 2012;133(1):127–35. https://doi.org/10.1007/s10549-011-1716-7.

    Article  CAS  PubMed  Google Scholar 

  99. Kauppila A, Kyyrönen P, Hinkula M, Pukkala E. Birth intervals and breast cancer risk. Br J Cancer. 2009;101(7):1213–7. https://doi.org/10.1038/sj.bjc.6605300.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Tworoger SS, Eliassen AH, Sluss P, Hankinson SE. A prospective study of plasma prolactin concentrations and risk of premenopausal and postmenopausal breast cancer. J Clin Oncol. 2007;25(12):1482–8. https://doi.org/10.1200/JCO.2006.07.6356.

    Article  CAS  PubMed  Google Scholar 

  101. Fazzo L, Carere M, Tisano F, Bruno C, Cernigliaro A, Cicero MR, et al. Cancer incidence in Priolo, Sicily: a spatial approach for estimation of industrial air pollution impact. Geospat Health. 2016;11:320.

    Article  PubMed  Google Scholar 

  102. Zimeri AM, Robb SW, Hassan SM, Hire RR, Davis MB. Assessing heavy metal and PCB exposure from tap water by measuring levels in plasma from sporadic breast cancer patients, a pilot study. Int J Environ Res Public Health. 2015;12(12):15683–91. https://doi.org/10.3390/ijerph121215013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Alatise OI, Schrauzer GN. Lead exposure: a contributing cause of the current breast cancer epidemic in Nigerian women. Biol Trace Elem Res. 2010;136(2):127–39. https://doi.org/10.1007/s12011-010-8608-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Little MP, McElvenny DM. Male breast cancer incidence and mortality risk in the Japanese atomic bomb survivors—differences in excess relative and absolute risk from female breast cancer. Environ Health Perspect. 2017;125(2):223–9. https://doi.org/10.1289/EHP151.

    PubMed  Google Scholar 

  105. Grant EJ, Brenner A, Sugiyama H, Sakata R, Sadakane A, Utada M, et al. Solid cancer incidence among the life span study of atomic bomb survivors: 1958-2009. Radiat Res. 2017;187(5):513–37. https://doi.org/10.1667/RR14492.1.

    Article  CAS  PubMed  Google Scholar 

  106. Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M. The benefits and harms of breast cancer screening: an independent review. Br J Cancer. 2013;108(11):2205–40. https://doi.org/10.1038/bjc.2013.177.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Kotepui M. Diet and risk of breast cancer. Contemp Oncol Poznan Pol. 2016;20:13–9.

    Google Scholar 

  108. Seitz HK, Pelucchi C, Bagnardi V, La Vecchia C. Epidemiology and pathophysiology of alcohol and breast cancer: update 2012. Alcohol Alcohol. 2012;47(3):204–12. https://doi.org/10.1093/alcalc/ags011.

    Article  PubMed  Google Scholar 

  109. Kim HJ, Jung S, Eliassen AH, Chen WY, Willett WC, Cho E. Alcohol consumption and breast cancer risk in younger women according to family history of breast cancer and folate intake. Am J Epidemiol. 2017;186(5):524–31. https://doi.org/10.1093/aje/kwx137.

    Article  PubMed  Google Scholar 

  110. Härmä M, Kecklund G. Shift work and health—how to proceed? Scand J Work Environ Health. 2010;36(2):81–4. https://doi.org/10.5271/sjweh.2902.

    Article  PubMed  Google Scholar 

  111. Charrier A, Olliac B, Roubertoux P, Tordjman S. Clock genes and altered sleep-wake rhythms: their role in the development of psychiatric disorders. Int J Mol Sci. 2017;18(5):E938. https://doi.org/10.3390/ijms18050938.

    Article  PubMed  Google Scholar 

  112. Wang X-S, Armstrong MEG, Cairns BJ, Key TJ, Travis RC. Shift work and chronic disease: the epidemiological evidence. Occup Med. 2011;61(2):78–89. https://doi.org/10.1093/occmed/kqr001.

    Article  Google Scholar 

  113. Schubauer-Berigan MK, Anderson JL, Hein MJ, Little MP, Sigurdson AJ, Pinkerton LE. Breast cancer incidence in a cohort of U.S. flight attendants. Am J Ind Med. 2015;58(3):252–66. https://doi.org/10.1002/ajim.22419.

    Article  PubMed  PubMed Central  Google Scholar 

  114. Wu AH, Kurian AW, Kwan ML, John EM, Lu Y, Keegan THM, et al. Diabetes and other comorbidities in breast cancer survival by race/ethnicity: the California Breast Cancer Survivorship Consortium (CBCSC). Cancer Epidemiol Biomarkers Prev. 2015;24(2):361–8. https://doi.org/10.1158/1055-9965.EPI-14-1140.

    Article  CAS  PubMed  Google Scholar 

  115. Xie C, Wang W, Li X, Shao N, Li W. Gestational diabetes mellitus and maternal breast cancer risk: a meta-analysis of the literature. J Matern-Fetal Neonatal Med. 2017;7:1–11.

    Google Scholar 

  116. Yeghiazaryan K, Cebioglu M, Golubnitschaja O. Global figures argue in favour of preventive measures and personalised treatment to optimise inadequate diabetes care. New Strateg. Adv. PreDiabetes Care Integr. Approach PPPM [Internet]. Dordrecht : Springer; 2013 [cited 2018 Jan 23]. p. 1–13. Available from: https://link.springer.com/chapter/10.1007/978-94-007-5971-8_1.

  117. Gaetani S, Romano A, Provensi G, Ricca V, Lutz T, Passani MB. Eating disorders: from bench to bedside and back. J Neurochem. 2016;139(5):691–9. https://doi.org/10.1111/jnc.13848.

    Article  CAS  PubMed  Google Scholar 

  118. Jagielska G, Kacperska I. Outcome, comorbidity and prognosis in anorexia nervosa. Psychiatr Pol. 2017;51(2):205–18. https://doi.org/10.12740/PP/64580.

    Article  PubMed  Google Scholar 

  119. Cox TR, Rumney RMH, Schoof EM, Perryman L, Høye AM, Agrawal A, et al. The hypoxic cancer secretome induces pre-metastatic bone lesions through lysyl oxidase. Nature. 2015;522(7554):106–10. https://doi.org/10.1038/nature14492.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  120. Konieczka K, Ritch R, Traverso CE, Kim DM, Kook MS, Gallino A, et al. Flammer syndrome. EPMA J. 2014;5(1):11. https://doi.org/10.1186/1878-5085-5-11.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Golubnitschaja O, Debald M, Kuhn W, Yeghiazaryan K, Bubnov RV, Goncharenko VM, et al. Flammer syndrome and potential formation of pre-metastatic niches: a multi-centred study on phenotyping, patient stratification, prediction and potential prevention of aggressive breast cancer and metastatic disease. EPMA J. 2016;7:A25.

    Article  Google Scholar 

  122. Yeghiazaryan K, Flammer J, Golubnitschaja O. Predictive molecular profiling in blood of healthy vasospastic individuals: clue to targeted prevention as personalised medicine to effective costs. EPMA J. 2010;1(2):263–72. https://doi.org/10.1007/s13167-010-0032-3.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Golubnitschaja O. Feeling cold and other underestimated symptoms in breast cancer: anecdotes or individual profiles for advanced patient stratification? EPMA J. 2017;8(1):17–22. https://doi.org/10.1007/s13167-017-0086-6.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Golubnitschaja O, Filep N, Yeghiazaryan K, Blom HJ, Hofmann-Apitius M, Kuhn W. Multi-omic approach decodes paradoxes of the triple-negative breast cancer: lessons for predictive, preventive and personalised medicine. Amino Acids. 2017; https://doi.org/10.1007/s00726-017-2524-0.

  125. Eibye S, Kjær SK, Mellemkjær L. Incidence of pregnancy-associated cancer in Denmark, 1977-2006. Obstet Gynecol. 2013;122(3):608–17. https://doi.org/10.1097/AOG.0b013e3182a057a2.

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by the Charles University Research Fund (Progres Q39), by the MH CZ - DRO (Faculty Hospital Plzen - FNPl, 00669806), and by the National Sustainability Program I (NPU I) Nr. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic. The authors thank the European Association for Predictive, Preventive and Personalised Medicine (EPMA, Brussels) for professional and financial support of the project.

Author information

Authors and Affiliations

  1. Department of Histology and Embryology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic

    Jiri Polivka Jr.

  2. Biomedical Centre, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic

    Jiri Polivka Jr.

  3. CEMBIO, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany

    Irem Altun

  4. Radiological Clinic, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str 25, 53105, Bonn, Germany

    Olga Golubnitschaja

  5. Breast Cancer Research Centre, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany

    Olga Golubnitschaja

  6. Centre for Integrated Oncology, Cologne-Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany

    Olga Golubnitschaja

Authors
  1. Jiri Polivka Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Irem Altun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olga Golubnitschaja
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

OG is the project coordinator who has created the main scientific concepts presented in the manuscript. JP Jr. has performed the literature search, analysed the data, and drafted the manuscript. IA has contributed to the literature search, data collection and analysis and concepts’ development. OG and JP Jr. have designed the final version of the manuscript.

Corresponding author

Correspondence to Olga Golubnitschaja.

Ethics declarations

Not applicable.

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of informed consent

Patients have not been involved in the study.

Statement of human and animal rights

No experiments have been performed including patients and/or animals.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Polivka, J., Altun, I. & Golubnitschaja, O. Pregnancy-associated breast cancer: the risky status quo and new concepts of predictive medicine. EPMA Journal 9, 1–13 (2018). https://doi.org/10.1007/s13167-018-0129-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13167-018-0129-7

Keywords

Search

Navigation