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dc.contributor.authorNichols, Hazel B.
dc.contributor.authorSchoemaker, Minouk J.
dc.contributor.authorCai, Jianwen
dc.contributor.authorXu, Jiawei
dc.contributor.authorWright, Lauren B.
dc.contributor.authorBrook, Mark N.
dc.contributor.authorJones, Michael E.
dc.contributor.authorAdami, Hans Olov
dc.contributor.authorBaglietto, Laura
dc.contributor.authorBertrand, Kimberly A.
dc.contributor.authorBlot, William J.
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorDorronsoro, Miren
dc.contributor.authorDossus, Laure
dc.contributor.authorEliassen, A. Heather
dc.contributor.authorGiles, Graham G.
dc.contributor.authorGram, Inger Torhild
dc.contributor.authorHankinson, Susan E.
dc.contributor.authorHoffman-Bolton, Judy
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKey, Timothy J.
dc.contributor.authorKitahara, Cari M.
dc.contributor.authorLarsson, Susanna C.
dc.contributor.authorLinet, Martha
dc.contributor.authorMerritt, Melissa A.
dc.contributor.authorMilne, Roger L.
dc.contributor.authorPala, Valeria
dc.contributor.authorPalmer, Julie R.
dc.contributor.authorPeeters, Petra H.
dc.contributor.authorRiboli, Elio
dc.contributor.authorSund, Malin
dc.contributor.authorTamimi, Rulla M.
dc.contributor.authorTjønneland, Anne
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorUrsin, Giske
dc.contributor.authorVatten, Lars Johan
dc.contributor.authorVisvanathan, Kala
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorWolk, Alicja
dc.contributor.authorZheng, Wei
dc.contributor.authorWeinberg, Clarice R.
dc.contributor.authorSwerdlow, Anthony J.
dc.contributor.authorSandler, Dale P.
dc.date.accessioned2020-03-17T13:53:09Z
dc.date.available2020-03-17T13:53:09Z
dc.date.issued2019-01-01
dc.description.abstract<i>Background</i>: Parity is widely recognized as protective for breast cancer, but breast cancer risk may be increased shortly after childbirth. Whether this risk varies with breastfeeding, family history of breast cancer, or specific tumor subtype has rarely been evaluated.<p> <p><i>Objective</i>: To characterize breast cancer risk in relation to recent childbirth.<p> <p>Design</i> : Pooled analysis of individual-level data from 15 prospective cohort studies.<p> <p><i>Setting</i>: The international Premenopausal Breast Cancer Collaborative Group.<p> <p><i>Participants</i>: Women younger than 55 years.<p> <p><i>Measurements</i>: During 9.6 million person-years of follow-up, 18 826 incident cases of breast cancer were diagnosed. Hazard ratios (HRs) and 95% CIs for breast cancer were calculated using Cox proportional hazards regression.<p> <p><i>Results</i>: Compared with nulliparous women, parous women had an HR for breast cancer that peaked about 5 years after birth (HR, 1.80 [95% CI, 1.63 to 1.99]) before decreasing to 0.77 (CI, 0.67 to 0.88) after 34 years. The association crossed over from positive to negative about 24 years after birth. The overall pattern was driven by estrogen receptor (ER)–positive breast cancer; no crossover was seen for ER-negative cancer. Increases in breast cancer risk after childbirth were pronounced when combined with a family history of breast cancer and were greater for women who were older at first birth or who had more births. Breastfeeding did not modify overall risk patterns.<p> <p><i>Limitations</i>: Breast cancer diagnoses during pregnancy were not uniformly distinguishable from early postpartum diagnoses. Data on human epidermal growth factor receptor 2 (HER2) oncogene overexpression were limited.<p> <p><i>Conclusion</i>: Compared with nulliparous women, parous women have an increased risk for breast cancer for more than 20 years after childbirth. Health care providers should consider recent childbirth a risk factor for breast cancer in young women.<p> <p><i>Primary Funding Source</i>: The Avon Foundation, the National Institute of Environmental Health Sciences, Breast Cancer Now and the UK National Health Service, and the Institute of Cancer Research.en_US
dc.identifier.citationNichols HB, Schoemaker MJ, Cai, Xu, Wright LB, Brook MN, Jones ME, Adami HO, Baglietto L, Bertrand KA, Blot WJ, Boutron-Ruault M, Dorronsoro M, Dossus L, Eliassen AH, Giles GG, Gram IT, Hankinson SE, Hoffman-Bolton J, Kaaks R, Key TJ, Kitahara CM, Larsson SC, Linet M, Merritt MA, Milne RL, Pala V, Palmer JR, Peeters PH, Riboli E, Sund M, Tamimi RM, Tjønneland A, Trichopoulou A, Ursin G, Vatten LJ, Visvanathan K, Weiderpass E, Wolk A, Zheng W, Weinberg CR, Swerdlow AJ, Sandler DP. Breast cancer risk after recent childbirth: A pooled analysis of 15 prospective studies. Annals of Internal Medicine. 2019;170(1):22-30en_US
dc.identifier.cristinIDFRIDAID 1691136
dc.identifier.doi10.7326/M18-1323
dc.identifier.issn0003-4819
dc.identifier.issn1539-3704
dc.identifier.urihttps://hdl.handle.net/10037/17775
dc.language.isoengen_US
dc.publisherAmerican College of Physiciansen_US
dc.relation.journalAnnals of Internal Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holder© 2018 American College of Physiciansen_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleBreast cancer risk after recent childbirth: A pooled analysis of 15 prospective studiesen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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