Association of pregnancy and mortality in women diagnosed with breast cancer: A Nationwide Population Based Study in Taiwan
Journal
International Journal of Cancer
Journal Volume
143
Journal Issue
10
Pages
2416-2424
Date Issued
2018
Author(s)
Abstract
We examined the associations between breast cancer diagnosed during pregnancy and up to 5 years postpartum and total mortality. Breast cancer patients were identified from the Taiwan Cancer Registry (2002–2014). All pregnancies up to 5 years before breast cancer diagnosis were abstracted from the National Health Insurance database and data were then linked to the Taiwan National Death Certificate Database. Follow-up was calculated from the date of breast cancer diagnosis to the date of death or 31 December, 2014, whichever came first. The hazard ratios (HRs) and the 95% confidence intervals (CI) of the association between pregnancy and total mortality were estimated using Cox proportional hazard models. Among the 30,230 breast cancer patients, 90 were diagnosed during pregnancy, 347 within a year postpartum, and 1993 during 1–5 years postpartum. By the end of 2014, 2,920 patients were dead. The major cause of death was breast cancer (89%). Compared to patients without pregnancy records, the HRs were 1.42 (95% CI = 0.83–2.45) for patients diagnosed during pregnancy, 1.29 (0.96–1.74) for those diagnosed within a year postpartum, 1.27 (0.95–1.70) for those diagnosed within 1 to 2 years postpartum, and 1.06 (0.88–1.27) for those diagnosed ?2 to 5 years postpartum, after adjustment for tumor characteristics and treatment. Subgroup analyses revealed an increased risk of mortality for patients diagnosed within a year postpartum in ER+ cancers (HR = 2.11, 95% CI = 1.28–3.47). Our results suggested a recent pregnancy may be associated with higher mortality among ER+ patients. ? 2018 UICC
Other Subjects
estrogen receptor; adult; Article; breast cancer; cancer mortality; cancer patient; cancer registry; cause of death; cohort analysis; controlled study; female; follow up; human; major clinical study; mortality risk; population research; pregnancy; priority journal; puerperium; retrospective study; Taiwan; breast tumor; epidemiology; factual database; middle aged; mortality; pregnancy; pregnancy complication; proportional hazards model; time factor; young adult; Adult; Breast Neoplasms; Cohort Studies; Databases, Factual; Female; Humans; Middle Aged; Postpartum Period; Pregnancy; Pregnancy Complications, Neoplastic; Proportional Hazards Models; Retrospective Studies; Taiwan; Time Factors; Young Adult
Publisher
Wiley-Liss Inc.
Type
journal article