title: Association of time since last birth, age at first birth and parity with breast cancer survival among parous women: a register-based study from Norway.
abstract: Reproductive factors that have a well-documented effect on breast cancer risk may also influence the prognosis of the disease, but previous studies on breast cancer survival have yielded conflicting results. We combined information from two population-based registries and obtained information on 16,970 parous women with invasive breast cancer. Cox regression analysis was used to assess breast cancer survival in relation to age at diagnosis, age at first birth, time since last birth and parity. We stratified the analyses by age at diagnosis (<50 and ≥ 50 years) as an approximation for menopausal age. In women diagnosed before 50 years of age, breast cancer survival was reduced with younger age at diagnosis (p for trend <0.001), whereas in women diagnosed at 50 years or later, survival was reduced with older age at diagnosis (p for trend 0.011). For breast cancer diagnosed before 50 years, survival was poorer in women with four or more births compared to women with one or two births (hazard ratio 1.3, 95% confidence interval 1.1-1.6). A short time since last birth was associated with reduced survival (p for trend 0.05), but adjustment for stage and grade attenuated the association. Among women diagnosed at 50 years or later, we found no association with survival for any of the reproductive factors. In summary, reproductive factors were associated with survival from breast cancer diagnosed before but not after age 50 years. Young women had a particularly poor prognosis throughout the study period.
authors.affiliation: Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway. mirjam.alsaker@ntnu.no
authors.forename: Mirjam D K
authors.initials: MD
authors.lastname: Alsaker
authors.forename: Signe
authors.initials: S
authors.lastname: Opdahl
authors.forename: Pål R
authors.initials: PR
authors.lastname: Romundstad
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Vatten
mesh_terms: D000328:Adult; D000367:Age Factors; D001722:Birth Order; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D017584:Reproductive History; D012306:Risk; D015996:Survival Rate