Pregnancy-Related Factors and Breast Cancer Risk for Women Across a Range of Familial Risk
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Published:2024-08-26
Issue:8
Volume:7
Page:e2427441
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
McDonald Jasmine A.1, Liao Yuyan1, Knight Julia A.23, John Esther M.4, Kurian Allison W.4, Daly Mary5, Buys Saundra S.6, Huang Yun7, Frost Caren J.8, Andrulis Irene L.29, Colonna Sarah V.10, Friedlander Michael L.11, Hopper John L.12, Chung Wendy K.1, Genkinger Jeanine M.1, MacInnis Robert J.1213, Terry Mary Beth1, , Amor David14, Andrews Lesley14, Antill Yoland14, Balleine Rosemary14, Beesley Jonathan14, Bennett Ian14, Bogwitz Michael14, Bodek Simon14, Botes Leon14, Brennan Meagan14, Brown Melissa14, Buckley Michael14, Burke Jo14, Butow Phyllis14, Caldon Liz14, Campbell Ian14, Cao Michelle14, Chakrabarti Anannya14, Chauhan Deepa14, Chauhan Manisha14, Chenevix-Trench Georgia14, Christian Alice14, Cohen Paul14, Colley Alison14, Crook Ashley14, Cui James14, Courtney Eliza14, Cummings Margaret14, Dawson Sarah-Jane14, deFazio Anna14, Delatycki Martin14, Dickson Rebecca14, Dixon Joanne14, Edwards Stacey14, Farshid Gelareh14, Fellows Andrew14, Fenton Georgina14, Field Michael14, Flanagan James14, Fong Peter14, Forrest Laura14, Fox Stephen14, French Juliet14, Friedlander Michael14, Gaff Clara14, Gattas Mike14, George Peter14, Greening Sian14, Harris Marion14, Hart Stewart14, Harraka Philip14, Hayward Nick14, Hopper John14, Hoskins Cass14, Hunt Clare14, James Paul14, Jenkins Mark14, Kidd Alexa14, Kirk Judy14, Koehler Jessica14, Kollias James14, Lakhani Sunil14, Lawrence Mitchell14, Lee Jason14, Li Shuai14, Lindeman Geoff14, Lippey Jocelyn14, Lipton Lara14, Lobb Liz14, Loi Sherene14, Mann Graham14, Marsh Deborah14, McLachlan Sue Anne14, Meiser Bettina14, Milne Roger14, Nightingale Sophie14, O'Connell Shona14, O'Sullivan Sarah14, Gallego Ortega David14, Pachter Nick14, Pang Jia-Min14, Pathak Gargi14, Patterson Briony14, Pearn Amy14, Phillips Kelly14, Pieper Ellen14, Ramus Susan14, Rickard Edwina14, Ragunathan Abi14, Robinson Bridget14, Saleh Mona14, Skandarajah Anita14, Salisbury Elizabeth14, Saunders Christobel14, Saunus Jodi14, Savas Peter14, Scott Rodney14, Scott Clare14, Sexton Adrienne14, Shaw Joanne14, Shelling Andrew14, Srinivasa Shweta14, Simpson Peter14, Southey Melissa14, Spurdle Amanda14, Taylor Jessica14, Taylor Renea14, Thorne Heather14, Trainer Alison14, Tucker Kathy14, Visvader Jane14, Walker Logan14, Williams Rachael14, Winship Ingrid14, Young Mary Ann14, Zaheed Milita14
Affiliation:
1. Columbia University Irving Medical Center, New York, New York 2. Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada 3. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada 4. Stanford University School of Medicine, Stanford, California 5. Fox Chase Cancer Center, Philadelphia, Pennsylvania 6. University of Utah Health Sciences Center, Salt Lake City 7. Ministry of Education, Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China 8. College of Social Work, The University of Utah, Salt Lake City 9. Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada 10. University of Utah Health Huntsman Cancer Institute, Salt Lake City 11. University of New South Wales, Sydney, New South Wales, Australia 12. Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia 13. Cancer Council Victoria, East Melbourne, Victoria, Australia 14. for the Kathleen Cuningham Foundation Consortium investigators
Abstract
ImportanceFew studies have investigated whether the associations between pregnancy-related factors and breast cancer (BC) risk differ by underlying BC susceptibility. Evidence regarding variation in BC risk is critical to understanding BC causes and for developing effective risk-based screening guidelines.ObjectiveTo examine the association between pregnancy-related factors and BC risk, including modification by a of BC where scores are based on age and BC family history.Design, Setting, and ParticipantsThis cohort study included participants from the prospective Family Study Cohort (ProF-SC), which includes the 6 sites of the Breast Cancer Family Registry (US, Canada, and Australia) and the Kathleen Cuningham Foundation Consortium (Australia). Analyses were performed in a cohort of women enrolled from 1992 to 2011 without any personal history of BC who were followed up through 2017 with a median (range) follow-up of 10 (1-23) years. Data were analyzed from March 1992 to March 2017.ExposuresParity, number of full-term pregnancies (FTP), age at first FTP, years since last FTP, and breastfeeding.Main Outcomes and MeasuresBC diagnoses were obtained through self-report or report by a first-degree relative and confirmed through pathology and data linkages. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% CIs for each exposure, examining modification by PARS of BC. Differences were assessed by estrogen receptor (ER) subtype.ResultsThe study included 17 274 women (mean [SD] age, 46.7 [15.1] years; 791 African American or Black participants [4.6%], 1399 Hispanic or Latinx participants [8.2%], and 13 790 White participants [80.7%]) with 943 prospectively ascertained BC cases. Compared with nulliparous women, BC risk was higher after a recent pregnancy for those women with higher PARS (last FTP 0-5 years HR for interaction, 1.53; 95% CI, 1.13-2.07; P for interaction < .001). Associations between other exposures were limited to ER-negative disease. ER-negative BC was positively associated with increasing PARS and increasing years since last FTP (P for interaction < .001) with higher risk for recent pregnancy vs nulliparous women (last FTP 0-5 years HR for interaction, 1.54; 95% CI, 1.03-2.31). ER-negative BC was positively associated with increasing PARS and being aged 20 years or older vs less than 20 years at first FTP (P for interaction = .002) and inversely associated with multiparity vs nulliparity (P for interaction = .01).Conclusions and RelevanceIn this cohort study of women with no prior BC diagnoses, associations between pregnancy-related factors and BC risk were modified by PARS, with greater associations observed for ER-negative BC.
Publisher
American Medical Association (AMA)
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