Primary breast and colon cancer: Is hypertension/preeclampsia during pregnancy an independent marker for individual risk stratification?

Introduction: Colon and breast cancer are leading causes of cancerrelated death in the Netherlands. Recently, the stroma-percentage within the primary tumor is described as an independent parameter for survival for both cancer types. Patients with high stroma-percentage had a worse survival independent for tumor stage and tumor status compared to patients with a high carcinoma-percentage. Pregnancy is also characterized by vaso-invasion. Abnormal function by angiogenesis, trophoblast, and stroma cells and their interaction play an important role in abnormal placentation, evident in preeclampsia, recurrent abortion, intra-uterine growth restriction, and abrutio placentae. The main goal of this study is to gain insight in the pathophysiology of breast en colon cancer early in a women's life using pregnancy as a stress test: women who had a complicated pregnancy characterized by abnormal angiogenesis may also have abnormal angiogenesis related to cancer associated with worse survival in later life. Methods: Patients included in the databases for breast (n = 234) and colon (n = 337) cancer have received an invitation to participate in this trial by filling out a validated questionnaire about their pregnancy outcomes. Stroma-percentage will be determined, and variables including tumor stage, tumor status, and smoking will be analyzed in a regression analysis. Hypothesis: We hypothesize that preeclampsia during pregnancy is an independent, early clinical genetic marker of invasion for abnormal placental growth (decreased angiogenesis), and associated with cancer with low stroma formation (and thus better prognosis).