Journal
EJSO
Volume 35, Issue 7, Pages 702-708Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2008.03.017
Keywords
Breast cancer; Survival; Parity; Nulliparity
Funding
- The Einar and Inga Nilsson Foundation
- The Maltno Univers ity Hospital Funds and Donations
- The Malmb University Hospital Cancer Foundation
- The Foundation for Surgical Research at Malmo University Hospital
- The Crafoord Foundation
- The Ernhold Lundstrom Foundation
- The Anna Lisa and Sven-Eric Lundgrens Foundation
- The Froken Anna Jonsson Foundation
- The Maggie Stephens Foundation
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Aim: The present study examines the association between parity and survival following breast cancer diagnosis. Methods: Medical records of 4453 women diagnosed with breast cancer in Malmo, Sweden, between 1961 and 1991 were analysed. All women were followed until 31 December 2003, using the Swedish Cause-of-Death Registry. Breast cancer specific mortality rate was calculated in different levels of parity. Corresponding relative risks, with 95% confidence intervals (CI), were obtained using Cox's proportional hazards analysis. All analyses were adjusted for potential prognostic factors and stratified for age, menopausal status and diagnostic period. Results: As compared to women with one child, nulliparity (RR 1.27: 95% CI 1.09-1.47), and high parity (four or more children) (1.49: 1.20-1.85) were positively associated with a high mortality from breast cancer. When adjusted for potential confounders, the association was only statistically significant for high parity (1.33: 1.07-1.66). In the analyses stratified on age and menopausal status, there was a similar positive association between high parity and breast cancer death in all strata, although only statistically significant among women older than 45 years of age or postmenopausal. Nulliparity was associated with breast cancer death in women that were younger than 45 years of age (1.28: 0.79-2.09) or premenopausal (1.30: 0.95-1.80), but these associations did not reach statistical significance. There was no association between nulliparity and breast cancer death in women older than 45 years of age or postmenopausal. All associations were similar in analyses stratified for diagnostic period. Conclusion: Women with four or more children have a poor breast cancer survival as compared to women with one child. (C) 2008 Elsevier Ltd. All rights reserved.
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