The Risk Of Breast Cancer Metastasis Is 50% Higher Among Women Diagnosed Within Five Years Of Childbirth, According To New Postpartum Study
Breast cancer is currently the second most common cancer among women in the United States, with about two hundred and fifty thousand new cases diagnosed every year, according to the CDC.
The long-known risk factors for this disease have included older age, genetic mutations, reproductive history, radiation therapy exposure, and family history.
But, a new study conducted by researchers at Oregon Health & Science University’s Knight Cancer Institute has found that breast cancers that develop within five years of childbirth are more likely to metastasize– or spread to other organs– and become fatal.
The study also revealed that recent childbirth is an independent breast cancer risk factor.
And unfortunately, these two discoveries suggest that current clinical guidelines are not equipped to both effectively predict cancer recurrence risk and inform treatment strategies since postpartum status is not taken into account.
“This has profound implications for prognosis. A postpartum diagnosis can move women who appear to have a good prognosis into a high-risk category,” said Pepper Schedin, a senior author of the study.
The team of researchers was first able to confirm a link between pregnancy and breast cancer outcomes by utilizing the Utah Population Database– which combines patient records, Utah Cancer Registry data, and statewide death and birth records.
Then, the study ultimately included nearly three thousand patients who were diagnosed with breast cancer at or under the age of forty-five.
Eight hundred and sixty of these patients never gave birth. And the patients who did were divided into three categories based on the amount of time since their most recent delivery.
Halfpoint – stock.adobe.com – illustrative purpose only, not the actual person
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The first group included patients who were diagnosed five years of childbirth. The second group of patients was diagnosed between five and ten years post-childbirth, and the third group received diagnoses ten or more years later.
The researchers then found that the risk of metastasis increased by fifty percent among women who were diagnosed with breast cancer within five years of childbirth.
And interestingly, this increased risk was persistent regardless of estrogen receptor status or tumor stage.
These are both two factors currently used to assess how aggressive a patient’s cancer will be and what courses of treatment are optimal.
Additionally, even though ER-negative tumors– or breast cancers that do not have estrogen receptors– are typically regarded as more dangerous than ER-positive tumors, this was not a significant factor in the study.
Instead, the most significant risk factor for breast cancer metastasis progression was a diagnosis within five years of giving birth.
Finally, the researchers made two critical findings regarding the causes of this increased risk. The first pertains to lactation, or rather, the end of it.
After women finish nursing, a majority of the milk-secreting cells undergo a process known as involution– or programmed cell death.
This process is similar to wound healing but, among mouse models, proved to foster an environment that promotes tumor growth.
The researchers then confirmed this mouse model finding among the study participants by collecting tissue samples.
The mouse model studies also revealed that as a woman’s liver tries to recover from the stress of pregnancy, it becomes a safe haven for cancer cells to grow.
The study confirmed this and found higher rates of breast cancer metastasis among women who were diagnosed within five years of giving birth.
“It’s a two-hit problem. Involution causes early tumor cells to get out of the breast. And those cancer cells find the liver to be a great host to establish metastatic tumors,” Schedin explained.
So now, the team is adamant that postpartum status be factored into clinicians’ screenings and breast cancer treatment approaches in order to best predict prognosis.
To read the study’s complete findings, which have since been published in JAMA Network Open, visit the link here.
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