{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T06:30:49Z","timestamp":1785047449703,"version":"3.55.0"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Few studies have investigated whether the associations between pregnancy-related factors and breast cancer (BC) risk differ by underlying BC susceptibility. Evidence regarding variation in BC risk is critical to understanding BC causes and for developing effective risk-based screening guidelines.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the association between pregnancy-related factors and BC risk, including modification by a of BC where scores are based on age and BC family history.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study included participants from the prospective Family Study Cohort (ProF-SC), which includes the 6 sites of the Breast Cancer Family Registry (US, Canada, and Australia) and the Kathleen Cuningham Foundation Consortium (Australia). Analyses were performed in a cohort of women enrolled from 1992 to 2011 without any personal history of BC who were followed up through 2017 with a median (range) follow-up of 10 (1-23) years. Data were analyzed from March 1992 to March 2017.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Parity, number of full-term pregnancies (FTP), age at first FTP, years since last FTP, and breastfeeding.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>BC diagnoses were obtained through self-report or report by a first-degree relative and confirmed through pathology and data linkages. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% CIs for each exposure, examining modification by PARS of BC. Differences were assessed by estrogen receptor (ER) subtype.<\/jats:p><\/jats:sec>Results<\/jats:title>The study included 17\u202f274 women (mean [SD] age, 46.7 [15.1] years; 791 African American or Black participants [4.6%], 1399 Hispanic or Latinx participants [8.2%], and 13\u202f790 White participants [80.7%]) with 943 prospectively ascertained BC cases. Compared with nulliparous women, BC risk was higher after a recent pregnancy for those women with higher PARS (last FTP 0-5 years HR for interaction, 1.53; 95% CI, 1.13-2.07; P<\/jats:italic> for interaction\u2009&amp;lt;\u2009.001). Associations between other exposures were limited to ER-negative disease. ER-negative BC was positively associated with increasing PARS and increasing years since last FTP (P<\/jats:italic> for interaction\u2009&amp;lt;\u2009.001) with higher risk for recent pregnancy vs nulliparous women (last FTP 0-5 years HR for interaction, 1.54; 95% CI, 1.03-2.31). ER-negative BC was positively associated with increasing PARS and being aged 20 years or older vs less than 20 years at first FTP (P<\/jats:italic> for interaction\u2009=\u2009.002) and inversely associated with multiparity vs nulliparity (P<\/jats:italic> for interaction\u2009=\u2009.01).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of women with no prior BC diagnoses, associations between pregnancy-related factors and BC risk were modified by PARS, with greater associations observed for ER-negative BC.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.27441","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T15:32:33Z","timestamp":1724686353000},"page":"e2427441","source":"Crossref","is-referenced-by-count":8,"title":["Pregnancy-Related Factors and Breast Cancer Risk for Women Across a Range of Familial Risk"],"prefix":"10.1001","volume":"7","author":[{"given":"Jasmine A.","family":"McDonald","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyan","family":"Liao","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia A.","family":"Knight","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther M.","family":"John","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison W.","family":"Kurian","sequence":"additional","affiliation":[{"name":"Stanford University 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Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene L.","family":"Andrulis","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada"},{"name":"Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah V.","family":"Colonna","sequence":"additional","affiliation":[{"name":"University of Utah Health Huntsman Cancer Institute, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Friedlander","sequence":"additional","affiliation":[{"name":"University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Hopper","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, 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