Breast Cancer Research and Treatment

, Volume 103, Issue 1, pp 93–102 | Cite as

Association between reproductive factors and breast cancer survival in younger women

  • Katrina F. Trivers
  • Marilie D. Gammon
  • Page E. Abrahamson
  • Mary Jo Lund
  • Elaine W. Flagg
  • Jay S. Kaufman
  • Patricia G. Moorman
  • Jianwen Cai
  • Andrew F. Olshan
  • Peggy L. Porter
  • Louise A. Brinton
  • J. William Eley
  • Ralph J. Coates
Original Paper


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.


Breast cancer Reproductive factors Reproductive history Survival 



American Joint Committee on Cancer


Body mass index


Confidence interval


Estrogen receptor positive




Hazard ratio


National Death Index


New Jersey


Surveillance, Epidemiology, and End Results Program


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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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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Katrina F. Trivers
    • 1
  • Marilie D. Gammon
    • 1
  • Page E. Abrahamson
    • 1
    • 2
  • Mary Jo Lund
    • 3
    • 9
  • Elaine W. Flagg
    • 4
  • Jay S. Kaufman
    • 1
  • Patricia G. Moorman
    • 5
  • Jianwen Cai
    • 6
  • Andrew F. Olshan
    • 1
  • Peggy L. Porter
    • 7
  • Louise A. Brinton
    • 8
  • J. William Eley
    • 9
  • Ralph J. Coates
    • 10
  1. 1.Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Cancer Prevention ProgramFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  4. 4.Surveillance and Epidemiology Branch, Division of Global Migration and Quarantine, National Center for Infectious DiseasesCenters for Disease Control and PreventionAtlantaUSA
  5. 5.Department of Community and Family Medicine, Cancer Prevention and Control Research ProgramDuke University Medical CenterDurhamUSA
  6. 6.Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillUSA
  7. 7.Division of Human BiologyFred Hutchinson Cancer Research CenterSeattleUSA
  8. 8.Division of Cancer Epidemiology and Genetics, Department of Health and Human ServicesNational Cancer Institute, National Institutes of HealthBethesdaUSA
  9. 9.Winship Cancer CenterEmory University School of MedicineAtlantaUSA
  10. 10.Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA

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