TY - JOUR
T1 - Overall survival is the lowest among young women with postpartum breast cancer
AU - Shagisultanova, Elena
AU - Gao, Dexiang
AU - Callihan, Eryn
AU - Parris, Hannah J.
AU - Risendal, Betsy
AU - Hines, Lisa M.
AU - Slattery, Martha L.
AU - Baumgartner, Kathy
AU - Schedin, Pepper
AU - John, Esther M.
AU - Borges, Virginia F.
N1 - Funding Information:
AACR-BCRF 09-06-26BORG grant to VB, Glass and Connor Family Foundations awards to VB; CDMRP DOD BC060531 and R01CA169175 award to VB and PS; NIH/NCATS CCTSI KL2TR001080 and NIH 1K08CA241071 awards to ES; NIH/NCATS CTSI UL1 TR001082 for RedCap; University of Colorado Cancer Center support grant P3CA046934 . The Breast Cancer Health Disparities Study funded by NIH CA14002 . The 4-Corners Breast Cancer Study is supported by NIH CA078682 , CA078762 , CA078552 and CA078802 ; NIH contract #N01-PC-67000 with Utah Cancer Registry with support from Utah Department of Health ; CDC and National Program of Cancer Registries funds to New Mexico, Arizona and Colorado Cancer Registries, with state support. The San Francisco Bay Area Breast Cancer Study is supported by NIH CA63446 and CA77305, DOD DAMD17-96-1-6071 award and 7 PB-0068 from the California Breast Cancer Research Program.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Background: Women diagnosed with breast cancer prior to age 45 years (<45y) and within the first 5 years postpartum (postpartum breast cancer, PPBC) have the greatest risk for distal metastatic recurrence. Methods: Pooling data from the Colorado Young Women Breast Cancer cohort and the Breast Cancer Health Disparities Study (N = 2519 cases), we examined the association of parity, age, and clinical factors with overall survival (OS) of breast cancer over 15 years of follow-up. Results: Women with PPBC diagnosed at <45y had the lowest OS (p < 0.0001), while OS of nulliparous cases diagnosed at <45y did not differ from OS of cases diagnosed at 45-65y regardless of parity status. After adjustment for study site, race/ethnicity, clinical stage, year of diagnosis and stratification for oestrogen receptor status, PPBC remained an independent factor associated with poor OS. Among cases diagnosed at <45y, nulliparous cases had 1.6 times better OS (hazard ratio (HR) = 0.61, 95%CI 0.42–0.87) compared to those with PPBC, with a more pronounced survival difference among stage I breast cancers (HR = 0.30, 95%CI 0.11–0.79). Among very young women diagnosed at age ≤35y, nulliparous cases had 2.3 times better OS (HR = 0.44, 95%CI 0.23–0.84) compared to PPBC. Conclusion: Our results suggest that postpartum status is the main driver of poor prognosis in young women with breast cancer, with the strongest association in patients diagnosed at age ≤35y and in those with stage I disease.
AB - Background: Women diagnosed with breast cancer prior to age 45 years (<45y) and within the first 5 years postpartum (postpartum breast cancer, PPBC) have the greatest risk for distal metastatic recurrence. Methods: Pooling data from the Colorado Young Women Breast Cancer cohort and the Breast Cancer Health Disparities Study (N = 2519 cases), we examined the association of parity, age, and clinical factors with overall survival (OS) of breast cancer over 15 years of follow-up. Results: Women with PPBC diagnosed at <45y had the lowest OS (p < 0.0001), while OS of nulliparous cases diagnosed at <45y did not differ from OS of cases diagnosed at 45-65y regardless of parity status. After adjustment for study site, race/ethnicity, clinical stage, year of diagnosis and stratification for oestrogen receptor status, PPBC remained an independent factor associated with poor OS. Among cases diagnosed at <45y, nulliparous cases had 1.6 times better OS (hazard ratio (HR) = 0.61, 95%CI 0.42–0.87) compared to those with PPBC, with a more pronounced survival difference among stage I breast cancers (HR = 0.30, 95%CI 0.11–0.79). Among very young women diagnosed at age ≤35y, nulliparous cases had 2.3 times better OS (HR = 0.44, 95%CI 0.23–0.84) compared to PPBC. Conclusion: Our results suggest that postpartum status is the main driver of poor prognosis in young women with breast cancer, with the strongest association in patients diagnosed at age ≤35y and in those with stage I disease.
KW - Breast cancer
KW - Overall survival
KW - Postpartum breast cancer
KW - Young women's breast cancer
UR - http://www.scopus.com/inward/record.url?scp=85129958465&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129958465&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2022.03.014
DO - 10.1016/j.ejca.2022.03.014
M3 - Article
C2 - 35525161
AN - SCOPUS:85129958465
VL - 168
SP - 119
EP - 127
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
ER -