Understanding Trends in Incidence and Management of Pregnancy‐Associated Breast Cancer in a National Sample Using Claims Data
ABSTRACT
Background and Objectives
Breast cancer incidence in young women is increasing globally. Here, we examine trends in incidence, management, and reconstruction for pregnancy‐associated breast cancer (PABC) in women 18–45.
Methods
Females aged 18–45 with breast cancer between 2007 and 2021 were identified in the Merative MarketScan Commercial and Multi‐State Medicaid Databases. We analyzed trends in incidence of PABC, treatments, and latency to treatments for PABC versus non‐PABC.
Results
A total of 1189 patients with PABC and 36 683 with non‐PABC were included. Over the study period, the proportion of breast cancer cases classified as PABC increased (2.36% of cases from 2007 to 2009, to 3.94% from 2019 to 2021; p < 0.001). Patients with PABC experienced higher rates of neoadjuvant chemotherapy, mastectomy, trastuzumab, and ovarian suppression therapy than patients with non‐PABC, and lower rates of adjuvant radiation and breast conserving surgery (p ≤ 0.001). PABC status did not independently predict increased latency from diagnosis to tumor resection surgery when controlling for receipt of neoadjuvant chemotherapy (p = 0.154). Patients with PABC experienced comparable rates of delayed or immediate implant and autologous reconstruction as patients with non‐PABC, but experienced increased latency to delayed implant reconstruction (p < 0.001).
Conclusions
PABC rates are increasing among women 45 and younger. Patients with PABC experience differences in types of medical/surgical treatments received and timing of post‐mastectomy reconstruction.