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In this multicenter Chinese cohort, we aimed to validate and extend prior observations regarding the association between time since recent childbirth, clinicopathological features, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included 12\u2009453 patients aged 18\u201355\u2009years with stage I to IV breast cancer for descriptive analyses; stage\u2010restricted sub\u2010cohorts were used for specific survival and modeling analyses as described below. These patients were diagnosed at three hospitals from July 1989 to June 2023, followed up until November 2023. The main exposures were diagnoses during pregnancy or the interval between the most recent childbirth and the diagnoses. The two primary outcomes assessed were disease\u2010free survival (DFS) and breast cancer\u2010specific death (BCSS). Cox proportional hazard models were employed to examine associations between exposures and outcomes. A nomogram using the least absolute shrinkage and selection operator (LASSO) penalty for variable selection. Model performance was evaluated using area under curve (AUC), decision curve analysis (DCA) curves and calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 12\u2009453 patients, 113 (0.9%) were diagnosed during pregnancy and 12\u2009340 after childbirth. Patients diagnosed within 5\u2009years after childbirth showed more aggressive clinicopathological characteristics, including larger tumors, more lymph node metastasis, and a higher Ki67 index. In contrast, results for PrBC should be interpreted cautiously because of the small sample size and potential treatment\u2010related confounding. The poor prognosis of PPBC is potentially linked to an increased risk of liver and brain metastases. Multivariate analysis indicates that a short interval between childbirth and diagnosis is an independent risk factor for breast cancer prognosis. Predictors included in the nomogram were time interval between childbirth and diagnosis of breast cancer, T stage, N stage, and pathological subtype. The AUCs for 1\u2010, 3\u2010, and 5\u2010year DFS prediction were 0.819, 0.767, and 0.731 in the training cohort and 0.818, 0.748, and 0.735 in the validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients diagnosed with PPBC within 10\u2009years after their most recent pregnancy, particularly within 5\u2009years, had increased risks of recurrence, metastasis, and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70577","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:04:16Z","timestamp":1780628656000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Pathological Characteristics and Prognosis of Breast Cancer During Pregnancy and Postpartum: A Multicenter Retrospective Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8920-2579","authenticated-orcid":false,"given":"Liying","family":"Wang","sequence":"first","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center Sun Yat\u2010Sen Memorial Hospital, Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heran","family":"Deng","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center Sun Yat\u2010Sen Memorial Hospital, Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery The Affiliated Hospital of Zunyi Medical University, Zunyi Medical University  Zunyi Guizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TaoLang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery The Affiliated Hospital of Zunyi Medical University, Zunyi Medical University  Zunyi Guizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianjun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Traditional Chinese Medicine Hospital of Guangdong Province, Guangzhou University of Chinese Medicine  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieqiong","family":"Liu","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center Sun Yat\u2010Sen Memorial Hospital, Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)61092\u20101"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13058\u2010022\u201001553\u20109"},{"issue":"3","key":"e_1_2_15_4_1","first-page":"235","article-title":"The Relation of Reproductive Factors to Mortality From Breast Cancer","volume":"11","author":"Daling J. 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