Association between reproductive factors and breast cancer survival in younger women
Association between reproductive factors and breast cancer survival in younger women
复制标题
DOI：
10.1007/s10549-006-9346-1
复制
发表时间：
2007-05-01
影响因子：
3.8
通讯作者：
Coates, Ralph J.
中科院分区：
文献类型：
--
作者：
Trivers, Katrina F.;Gammon, Marilie D.;Coates, Ralph J.
该分析调查了诸如初潮年龄、胎次、妊娠时间和结局等生殖因素是否与55岁以下乳腺癌患者的生存有关。亚特兰大、乔治亚州和新泽西州中部的女性居民在1990年至1992年间被诊断为原发性侵袭性乳腺癌，并参加了一项基于人群的研究（n = 1264），随访8-10年。通过诊断后不久进行的面对面访谈收集了详细的暴露和协变量信息。截至2000年1月1日的生命状况是通过国家癌症登记处的国家死亡指数确定的（n = 292例死亡）。采用Cox回归方法估计混杂因素调整后的风险比（HR）和95%置信区间（CI）。与无胎产相比，4胎及以上胎产与全因死亡率呈正相关[HR (95% CI) = 1.71(1.09-2.67)]。死亡率增加与诊断前5年内（5年）分娩有关[1.78(1.28-2.47)]，并且在诊断前体重指数< 25 kg/m(2)[2.54(1.61-4.00)]的妇女中更为明显。初潮年龄早和初产年龄早也会适度增加死亡率；流产史、人工流产史和曾经母乳喂养史与生存率无关。这些结果可能有助于阐明乳腺癌的进展机制，并使人们更好地了解生殖特征如何影响乳腺癌的生存。
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 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.