Postpartum-associated breast cancer: Patient outcomes analysis.

Abstract

e12697 Background: Postpartum-associated breast cancer (PABC) has been defined clinically as breast cancer (BC) diagnosed within the first 5 years of the most recent birth. Though generally rare, incidence rates are increasing in conjunction with delayed childbearing and older maternal age at first birth. Currently, there are limited data regarding serial patient-reported outcomes in this patient population compared to non-PABC patients. Methods: Patients with PABC from the Mayo Clinic Breast Disease Registry who completed baseline, 2, and 4-year surveys were matched 1:1 to BC patients whose cancers occurred more than 5 years after their most recent birth (or in the setting of nulliparity) based on age, clinical stage, treatment received, and tumor subtype. Survey results from the Patient Health Questionnaire-2 (PHQ-2), Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10), and Impact of Event Scale-Revised (IES-R) collected at approximately two and four years after diagnosis were compared between PABC and non-PABC patients. Univariable analyses used Wilcoxon rank sum tests, whereas multivariable analyses employed linear regression models adjusting for potential confounding effects. Results: A total of 222 individuals were included (111 with PABC). A higher proportion of individuals in the PABC cohort were married compared to the non-PABC cohort (80% vs. 42%, p < 0.001); otherwise, the groups were well-balanced across multiple categories, including age, gender, race/ethnicity, menopausal status, and germline mutation status. In univariable analyses, the Year 2 composite PHQ-2 score was significantly worse among individuals with non-PABC (p = 0.04), and the non-PABC cohort reported greater difficulty with sleep (p = 0.03) as measured by IES-R at Year 4. Both associations attenuated in a multivariable analysis controlling for marital status. In marital status-adjusted analyses of Year 4 survey results, PABC participants reported greater difficulty in carrying out social activities but were less likely to report emotional distress as evaluated by PROMIS-10 (compared with non-PABC participants). No other variables were significant univariably or multivariably (p > 0.05). Conclusions: In general, quality of life is similar among survivors of PABC compared to those diagnosed with breast cancer outside the postpartum period (or when nulliparous). However, our findings reveal that individuals with PABC are less likely to experience emotional distress 2 and 4 years after the BC diagnosis, which is unexpected, given that postpartum patients typically report higher levels of distress compared to their non-postpartum counterparts. Further investigation into these findings is warranted.