Abstract
This analysis investigated whether reproductive factors such as age at menarche, parity, and timing and outcomes of pregnancies were associated with survival among women with breast cancer younger than 55 years. Female residents of Atlanta, Georgia, and central New Jersey who were diagnosed with a primary, incident invasive breast cancer between 1990 and 1992 and enrolled in a population-based study (n = 1,264) were followed for 8–10 years. Detailed exposure and covariate information was collected via in-person interviews administered shortly after diagnosis. Vital status as of January 1, 2000 was ascertained through the National Death Index via the state cancer registries (n = 292 deaths). Cox regression methods were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for confounders. Parity of 4 or more births, as compared with nulliparity, was positively associated with all-cause mortality, [HR (95% CI) = 1.71 (1.09–2.67)]. Increased mortality was associated with having given birth within 5 years prior to diagnosis (≤5 vs. >5 years) [1.78 (1.28–2.47)], and was more pronounced among women with a pre-diagnostic body mass index of <25 kg/m2 [2.54 (1.61–4.00)]. Early age at menarche and early age at first birth also modestly increased mortality; history of miscarriage, induced abortion, and ever breastfeeding were not related to survival. These results may help elucidate breast cancer progression mechanisms and enable a better understanding of how reproductive characteristics influence breast cancer survival.
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Abbreviations
- AJCC:
-
American Joint Committee on Cancer
- BMI:
-
Body mass index
- CI:
-
Confidence interval
- ER+:
-
Estrogen receptor positive
- GA:
-
Georgia
- HR:
-
Hazard ratio
- NDI:
-
National Death Index
- NJ:
-
New Jersey
- SEER:
-
Surveillance, Epidemiology, and End Results Program
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Acknowledgments
Supported in part by grants from the Susan G. Komen Breast Cancer Foundation (DISS0402898), the National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services (P30ES10126), Cancer Epidemiology Training Grant (T32 CA09330) and the UNC Lineberger Cancer Control Education Program (R25 CA57726).
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
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Trivers, K.F., Gammon, M.D., Abrahamson, P.E. et al. Association between reproductive factors and breast cancer survival in younger women. Breast Cancer Res Treat 103, 93–102 (2007). https://doi.org/10.1007/s10549-006-9346-1
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DOI: https://doi.org/10.1007/s10549-006-9346-1