Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status

Jia Yi Zhang, Mei Xia Wang, Xiang Wang, Yue Lin Li, Zhuo Zhi Liang, Ying Lin, Qiang Liu, Xiao Ming Xie, Lu Ying Tang, Ze Fang Ren

Research output: Contribution to journalArticle

Abstract

Reproductive factors associated with breast cancer risk may also affect the prognosis. This study aimed to evaluate the associations of multiple reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. We obtained data from 3805 breast cancer patients recruited between October 2008 and June 2016 in Guangzhou. The subjects were followed up until 30 June 2018. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using multivariate Cox models to estimate the associations. It was found that there were U-shaped patterns for the associations of age at first birth and durations from first/last birth to diagnosis with breast cancer prognosis. The adverse effects of old age at first birth [>30 years vs 23-30 years, HR (95% CI): 1.59 (1.01-2.50)] and long intervals from first [≥20 years vs 10-19 years, HR (95% CI): 1.55 (1.07-2.27)] or last [≥20 years vs 10-19 years, HR (95% CI): 1.63 (1.08-2.46)] birth to diagnosis on progression-free survival (PFS) were significantly more pronounced among premenopausal women. Additionally, long interval (>5 years) between first and second birth was associated with a better PFS [HR (95% CI): 0.64 (0.42-0.97)]. These results suggested that age at first birth, durations from first/last birth to diagnosis, and intervals between first and second birth should be taken into account when following the patients and assessing the prognosis of breast cancer, particularly for premenopausal patients. These findings would also have implications for further insight into the mechanisms of breast cancer development.

Original languageEnglish (US)
Pages (from-to)385-393
Number of pages9
JournalCancer medicine
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2020

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Birth Order
Breast Neoplasms
Confidence Intervals
Disease-Free Survival
Proportional Hazards Models
Parturition

Keywords

  • breast cancer
  • menopausal status
  • prognosis
  • reproductive factors

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Zhang, J. Y., Wang, M. X., Wang, X., Li, Y. L., Liang, Z. Z., Lin, Y., ... Ren, Z. F. (2020). Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. Cancer medicine, 9(1), 385-393. https://doi.org/10.1002/cam4.2707

Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. / Zhang, Jia Yi; Wang, Mei Xia; Wang, Xiang; Li, Yue Lin; Liang, Zhuo Zhi; Lin, Ying; Liu, Qiang; Xie, Xiao Ming; Tang, Lu Ying; Ren, Ze Fang.

In: Cancer medicine, Vol. 9, No. 1, 01.01.2020, p. 385-393.

Research output: Contribution to journalArticle

Zhang, JY, Wang, MX, Wang, X, Li, YL, Liang, ZZ, Lin, Y, Liu, Q, Xie, XM, Tang, LY & Ren, ZF 2020, 'Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status', Cancer medicine, vol. 9, no. 1, pp. 385-393. https://doi.org/10.1002/cam4.2707
Zhang, Jia Yi ; Wang, Mei Xia ; Wang, Xiang ; Li, Yue Lin ; Liang, Zhuo Zhi ; Lin, Ying ; Liu, Qiang ; Xie, Xiao Ming ; Tang, Lu Ying ; Ren, Ze Fang. / Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. In: Cancer medicine. 2020 ; Vol. 9, No. 1. pp. 385-393.
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abstract = "Reproductive factors associated with breast cancer risk may also affect the prognosis. This study aimed to evaluate the associations of multiple reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. We obtained data from 3805 breast cancer patients recruited between October 2008 and June 2016 in Guangzhou. The subjects were followed up until 30 June 2018. The hazard ratios (HRs) and 95{\%} confidence intervals (95{\%} CIs) were calculated using multivariate Cox models to estimate the associations. It was found that there were U-shaped patterns for the associations of age at first birth and durations from first/last birth to diagnosis with breast cancer prognosis. The adverse effects of old age at first birth [>30 years vs 23-30 years, HR (95{\%} CI): 1.59 (1.01-2.50)] and long intervals from first [≥20 years vs 10-19 years, HR (95{\%} CI): 1.55 (1.07-2.27)] or last [≥20 years vs 10-19 years, HR (95{\%} CI): 1.63 (1.08-2.46)] birth to diagnosis on progression-free survival (PFS) were significantly more pronounced among premenopausal women. Additionally, long interval (>5 years) between first and second birth was associated with a better PFS [HR (95{\%} CI): 0.64 (0.42-0.97)]. These results suggested that age at first birth, durations from first/last birth to diagnosis, and intervals between first and second birth should be taken into account when following the patients and assessing the prognosis of breast cancer, particularly for premenopausal patients. These findings would also have implications for further insight into the mechanisms of breast cancer development.",
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