title: Impact of recent parity on histopathological tumor features and breast cancer outcome in premenopausal Japanese women.
abstract: Although previous studies have reported that onset at young age is associated with poor prognosis in breast cancer, the correlation between reproductive factors, breast cancer characteristics, and prognosis remains unclear. Five hundred and twenty-six premenopausal young women diagnosed with primary invasive breast cancer between January 2000 and December 2007 were included in this study. Patients were classified into four groups according to their reproductive history: women who gave birth within the previous 2 years (group A), women who gave birth between 3 and 5 years previously (group B), women who gave birth more than 5 years previously (group C), and nulliparous women (group N). The correlation between the time since last childbirth to diagnosis, histopathological tumor features, and breast cancer prognosis was evaluated. Breast cancer patients who had given birth more recently had more advanced stage tumors; larger sized tumors; a higher rate of axillary lymph node metastases; a higher histological tumor grade; and increased progesterone receptor (PgR)-, HER2+, and triple negative tumors than patients who had given birth less recently or not at all. Group A patients had significantly shorter survival times than patients in both groups C and N (log rank test; p < 0.001). After adjusting for tumor characteristics, the hazard ratio for death in group A was 2.19 compared with group N (p = 0.036), and the adjusted hazard ratio restricted to patients in group A with hormone-receptor-positive, and HER2- tumors was 3.07 (p = 0.011). Young breast cancer patients who had given birth more recently had tumors with more aggressive features and worse prognoses compared with patients who had given birth less recently or were nulliparous.
authors.affiliation: Division of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: Akiko Kawano
authors.initials: AK
authors.lastname: Nagatsuma
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Takahashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Shigehira
authors.initials: S
authors.lastname: Saji
authors.forename: Takashi
authors.initials: T
authors.lastname: Hojo
authors.forename: Kokichi
authors.initials: K
authors.lastname: Sugano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Fujii
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D044466:Asian People; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D010298:Parity; D011247:Pregnancy; D017697:Premenopause; D011379:Prognosis; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D017584:Reproductive History; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human