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Breast Cancer Research
Published in: Breast Cancer Research 3/2010

Open Access 01-06-2010 | Research article

Pregnancy-related factors and the risk of breast carcinoma in situand invasive breast cancer among postmenopausal women in the California Teachers Study cohort

Authors: Huiyan Ma, Katherine D Henderson, Jane Sullivan-Halley, Lei Duan, Sarah F Marshall, Giske Ursin, Pamela L Horn-Ross, Joan Largent, Dennis M Deapen, James V Lacey Jr, Leslie Bernstein

Published in: Breast Cancer Research | Issue 3/2010

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Abstract

Introduction

Although pregnancy-related factors such as nulliparity and late age at first full-term pregnancy are well-established risk factors for invasive breast cancer, the roles of these factors in the natural history of breast cancer development remain unclear.

Methods

Among 52,464 postmenopausal women participating in the California Teachers Study (CTS), 624 were diagnosed with breast carcinoma in situ (CIS) and 2,828 with invasive breast cancer between 1995 and 2007. Multivariable Cox proportional hazards regression methods were used to estimate relative risks associated with parity, age at first full-term pregnancy, breastfeeding, nausea or vomiting during pregnancy, and preeclampsia.

Results

Compared with never-pregnant women, an increasing number of full-term pregnancies was associated with greater risk reduction for both breast CIS and invasive breast cancer (both P trend < 0.01). Women having four or more full-term pregnancies had a 31% lower breast CIS risk (RR = 0.69, 95% CI = 0.51 to 0.93) and 18% lower invasive breast cancer risk (RR = 0.82, 95% CI = 0.72 to 0.94). Parous women whose first full-term pregnancy occurred at age 35 years or later had a 118% greater risk for breast CIS (RR = 2.18, 95% CI = 1.36 to 3.49) and 27% greater risk for invasive breast cancer (RR = 1.27, 95% CI = 0.99 to 1.65) than those whose first full-term pregnancy occurred before age 21 years. Furthermore, parity was negatively associated with the risk of estrogen receptor-positive (ER+) or ER+/progesterone receptor-positive (PR+) while age at first full-term pregnancy was positively associated with the risk of ER+ or ER+/PR+ invasive breast cancer. Neither of these factors was statistically significantly associated with the risk of ER-negative (ER-) or ER-/PR- invasive breast cancer, tests for heterogeneity between subtypes did not reach statistical significance. No clear associations were detected for other pregnancy-related factors.

Conclusions

These results provide some epidemiologic evidence that parity and age at first full-term pregnancy are involved in the development of breast cancer among postmenopausal women. The role of these factors in risk of in situ versus invasive, and hormone receptor-positive versus -negative breast cancer merits further exploration.
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Metadata
Title
Pregnancy-related factors and the risk of breast carcinoma in situand invasive breast cancer among postmenopausal women in the California Teachers Study cohort
Authors
Huiyan Ma
Katherine D Henderson
Jane Sullivan-Halley
Lei Duan
Sarah F Marshall
Giske Ursin
Pamela L Horn-Ross
Joan Largent
Dennis M Deapen
James V Lacey Jr
Leslie Bernstein
Publication date
01-06-2010
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 3/2010
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr2589

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