Breast Cancer Research and Treatment

, Volume 137, Issue 1, pp 297–305 | Cite as

Placental weight and mortality in premenopausal breast cancer by tumor characteristics

  • Mohammad Hossein Hajiebrahimi
  • Shahram Bahmanyar
  • Mats Lambe
  • Jan Adolfsson
  • Tommy Fornander
  • Fredrik Wärnberg
  • Sven Cnattingius


Placental weight may be regarded as an indirect marker of hormone exposures during pregnancy. There is epidemiological evidence that breast cancer mortality in premenopausal women increases with placental weight in the most recent pregnancy. We investigated if this association differs by tumor characteristics, including expression of estrogen and progesterone receptors. In a Swedish population-based cohort, we followed 1,067 women with premenopausal breast cancer diagnosed from 1992 to 2006. Using Cox regression models, we estimated hazard ratios for the association between placental weight and risk of premenopausal breast cancer mortality. In stratified analyses, we estimated mortality risks in subjects with different tumor stages, estrogen receptor (ER) or progesterone receptor (PR) status. Compared with women with placental weight less than 600 g, women with a placental weight between 600 and 699 g were at a 50 % increased risk of mortality, however, not significant change in risk was observed for women with placental weight ≥700 g. Mortality risks associated with higher placental weight were more pronounced among ER and PR breast cancer tumors, where both a placental weight 600–699 g and ≥700 g were associated with a more than doubled mortality risks compared with tumors among women with placental weight less than 600 g. Moreover, stratified analyses for joint receptor status revealed that a consistent increased mortality risk by placental weight was only apparent in women with ER/PR breast cancer. The increased mortality risk in premenopausal breast cancer associated with higher placental weight was most pronounced among ER and PR tumors.


Breast cancer Premenopausal Placental weight Estrogen receptor Progesterone receptor 



We are indebted to the members of the steering groups of the Quality registers on Breast Cancer (Stockholm-Gotland and Uppsala-Örebro regions), the National Board of Health and Welfare, and Statistics Sweden for providing data for this investigation. The study was supported by a grant from the Swedish Cancer Society (Grant Number: 2009/843) and by the Cancer Risk Prediction Center (CRiSP), a Linneus Centre (Contract ID 70867902) financed by the Swedish Research Council.

Ethical standards

The study was approved by the research ethics committee of Karolinska Institutet.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Mohammad Hossein Hajiebrahimi
    • 1
    • 8
  • Shahram Bahmanyar
    • 1
    • 2
    • 8
  • Mats Lambe
    • 3
    • 4
  • Jan Adolfsson
    • 5
  • Tommy Fornander
    • 6
  • Fredrik Wärnberg
    • 7
  • Sven Cnattingius
    • 1
  1. 1.Clinical Epidemiology Unit, Department of MedicineKarolinska InstitutetStockholmSweden
  2. 2.Center for Pharmacoepidemiology, Department of MedicineKarolinska InstitutetStockholmSweden
  3. 3.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
  4. 4.Regional Cancer CenterUppsalaSweden
  5. 5.Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden
  6. 6.Department of Oncology-PathologyKarolinska InstitutetStockholmSweden
  7. 7.Department of Surgical ScienceUppsala UniversityUppsalaSweden
  8. 8.Faculty of Public HealthGolestan University of Medical SciencesGorganIran

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