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Association between reproductive factors and breast cancer survival in younger women

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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.

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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).

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of North Carolina at Chapel Hill, CB #7435, Chapel Hill, NC, 27599-7435, USA

    Katrina F. Trivers, Marilie D. Gammon, Page E. Abrahamson, Jay S. Kaufman & Andrew F. Olshan

  2. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Page E. Abrahamson

  3. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Mary Jo Lund

  4. Surveillance and Epidemiology Branch, Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Elaine W. Flagg

  5. Department of Community and Family Medicine, Cancer Prevention and Control Research Program, Duke University Medical Center, Durham, NC, USA

    Patricia G. Moorman

  6. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jianwen Cai

  7. Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Peggy L. Porter

  8. Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Louise A. Brinton

  9. Winship Cancer Center, Emory University School of Medicine, Atlanta, GA, USA

    Mary Jo Lund & J. William Eley

  10. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Ralph J. Coates

Authors
  1. Katrina F. Trivers
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  2. Marilie D. Gammon
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  3. Page E. Abrahamson
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  4. Mary Jo Lund
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  5. Elaine W. Flagg
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  6. Jay S. Kaufman
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  7. Patricia G. Moorman
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  8. Jianwen Cai
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  9. Andrew F. Olshan
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  10. Peggy L. Porter
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  11. Louise A. Brinton
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  12. J. William Eley
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  13. Ralph J. Coates
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Correspondence to Katrina F. Trivers.

Additional information

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

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