title: Prediagnosis reproductive factors and all-cause mortality for women with breast cancer in the breast cancer family registry.
abstract: Studies have examined the prognostic relevance of reproductive factors before breast cancer diagnosis, but most have been small and their overall findings inconclusive. Associations between reproductive risk factors and all-cause mortality after breast cancer diagnosis were assessed with the use of a population-based cohort of 3,107 women of White European ancestry with invasive breast cancer (1,130 from Melbourne and Sydney, Australia; 1,441 from Ontario, Canada; and 536 from Northern California, United States). During follow-up with a median of 8.5 years, 567 deaths occurred. At recruitment, questionnaire data were collected on oral contraceptive use, number of full-term pregnancies, age at first full-term pregnancy, time from last full-term pregnancy to breast cancer diagnosis, breastfeeding, age at menarche, and menopause and menopausal status at breast cancer diagnosis. Hazard ratios for all-cause mortality were estimated with the use of Cox proportional hazards models with and without adjustment for age at diagnosis, study center, education, and body mass index. Compared with nulliparous women, those who had a child up to 2 years, or between 2 and 5 years, before their breast cancer diagnosis were more likely to die. The unadjusted hazard ratio estimates were 2.75 [95% confidence interval (95% CI), 1.98-3.83; P < 0.001] and 2.20 (95% CI, 1.65-2.94; P < 0.001), respectively, and the adjusted estimates were 2.25 (95% CI, 1.59-3.18; P < 0.001) and 1.82 (95% CI, 1.35-2.46; P < 0.001), respectively. When evaluating the prognosis of women recently diagnosed with breast cancer, the time since last full-term pregnancy should be routinely considered along with other established host and tumor prognostic factors, but consideration of other reproductive factors may not be warranted.
authors.affiliation: Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
authors.forename: Kelly-Anne
authors.initials: KA
authors.lastname: Phillips
authors.forename: Roger L
authors.initials: RL
authors.lastname: Milne
authors.forename: Dee W
authors.initials: DW
authors.lastname: West
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Goodwin
authors.forename: Graham G
authors.initials: GG
authors.lastname: Giles
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.forename: Jane C
authors.initials: JC
authors.lastname: Figueiredo
authors.forename: Michael L
authors.initials: ML
authors.lastname: Friedlander
authors.forename: Theresa H M
authors.initials: TH
authors.lastname: Keegan
authors.forename: Gord
authors.initials: G
authors.lastname: Glendon
authors.forename: Carmel
authors.initials: C
authors.lastname: Apicella
authors.forename: Frances P
authors.initials: FP
authors.lastname: O'Malley
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Southey
authors.forename: Irene L
authors.initials: IL
authors.lastname: Andrulis
authors.forename: Esther M
authors.initials: EM
authors.lastname: John
authors.forename: John L
authors.initials: JL
authors.lastname: Hopper
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D012042:Registries; D017584:Reproductive History; D012307:Risk Factors; D013995:Time