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/m
2 [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.
Keywords Breast cancer - Reproductive factors - Reproductive history - Survival
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.