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Erschienen in: Breast Cancer Research and Treatment 1/2013

01.11.2013 | Epidemiology

Reproductive factors and risk of premenopausal breast cancer by age at diagnosis: Are there differences before and after age 40?

verfasst von: Erica T. Warner, Graham A. Colditz, Julie R. Palmer, Ann H. Partridge, Bernard A. Rosner, Rulla M. Tamimi

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2013

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Abstract

We examined the relationship between reproductive factors and risk of premenopausal breast cancer among women less than age 40 compared with older premenopausal women. We documented 374 incident cases of breast cancer diagnosed before age 40, and 2,533 cases diagnosed at age 40 and older among premenopausal women in the Nurses’ Health Study cohorts. Biennial questionnaires were used to determine age at menarche, age at first birth, parity, breastfeeding, and other reproductive factors. Multivariate relative risks (RR) and 95 % confidence intervals (CI) were calculated using Cox proportional hazards models within age at diagnosis groups. Tumors in younger women were significantly more likely to be higher grade, larger size, and hormone receptor negative than were tumors in older premenopausal women (p < 0.0001). There was no significant heterogeneity according to age in associations between reproductive factors and risk of premenopausal breast cancer. First birth at age 30 or older increased breast cancer risk in both age groups (age <40: RR 1.10, 95 % CI 0.80–1.50; age ≥40: RR 1.16, 95 % CI 1.02–1.32; p-heterogeneity = 0.44). Risk of premenopausal breast cancer decreased with each additional year of age at menarche in both age groups (age <40: RR 0.93, 95 % CI 0.87–0.99; p trend = 0.02; age ≥40: RR 0.94, 95 % CI 0.91–0.97; p trend = <0.0001). Among premenopausal parous women, breastfeeding was protective regardless of age at diagnosis (age <40: RR 0.84, 95 % CI 0.57–1.22; age ≥40: RR 0.85, 95 % CI 0.72–0.99; p-heterogeneity = 0.79). In the largest prospective examination of reproductive risk factors and risk of breast cancer before and after age 40, we found that younger women were more likely to develop tumors with less favorable prognostic characteristics. However, associations between reproductive factors and risk of breast cancer were similar regardless of age at diagnosis of premenopausal breast cancer.
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Metadaten
Titel
Reproductive factors and risk of premenopausal breast cancer by age at diagnosis: Are there differences before and after age 40?
verfasst von
Erica T. Warner
Graham A. Colditz
Julie R. Palmer
Ann H. Partridge
Bernard A. Rosner
Rulla M. Tamimi
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 1/2013
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-013-2721-9

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