Original Paper

Breast Cancer Research and Treatment

, Volume 103, Issue 1, pp 93-102

First online:

Association between reproductive factors and breast cancer survival in younger women

  • Katrina F. TriversAffiliated withDepartment of Epidemiology, University of North Carolina at Chapel Hill Email author 
  • , Marilie D. GammonAffiliated withDepartment of Epidemiology, University of North Carolina at Chapel Hill
  • , Page E. AbrahamsonAffiliated withDepartment of Epidemiology, University of North Carolina at Chapel HillCancer Prevention Program, Fred Hutchinson Cancer Research Center
  • , Mary Jo LundAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityWinship Cancer Center, Emory University School of Medicine
  • , Elaine W. FlaggAffiliated withSurveillance and Epidemiology Branch, Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention
  • , Jay S. KaufmanAffiliated withDepartment of Epidemiology, University of North Carolina at Chapel Hill
  • , Patricia G. MoormanAffiliated withDepartment of Community and Family Medicine, Cancer Prevention and Control Research Program, Duke University Medical Center
  • , Jianwen CaiAffiliated withDepartment of Biostatistics, University of North Carolina at Chapel Hill
  • , Andrew F. OlshanAffiliated withDepartment of Epidemiology, University of North Carolina at Chapel Hill
    • , Peggy L. PorterAffiliated withDivision of Human Biology, Fred Hutchinson Cancer Research Center
    • , Louise A. BrintonAffiliated withDivision of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health
    • , J. William EleyAffiliated withWinship Cancer Center, Emory University School of Medicine
    • , Ralph J. CoatesAffiliated withDivision of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention

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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.

Keywords

Breast cancer Reproductive factors Reproductive history Survival