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The exact mechanisms that lead to poor prognosis in these patients are largely unknown.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We have evaluated the association of clinical and reproductive factors with BC in a cohort of women\u2009\u2264\u200945\u00a0years (<jats:italic>N<\/jats:italic>\u2009=\u2009155) with long-term follow-up. Based on duration since last childbirth (LCB), grouped patients into PPBC1 (LCB\u2009\u2264\u20095\u00a0years), PPBC2 (LCB between 6 and 10\u00a0years), PPBC3 (LCB\u2009&gt;\u200910\u00a0years), and NPBC (age-matched nulliparous BC patients). We compared disease-free survival and hazard associated with recurrence\/metastasis between the groups. RNA sequencing of tumor samples was performed from three parous groups (<jats:italic>n<\/jats:italic>\u2009=\u200910), and transcriptomic data were analyzed for differentially expressed genes and altered pathways.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Women in the PPBC1 group had an early menarche and late age at first and last childbirth compared to other groups. Survival analysis within lymph node-positive tumors showed that PPBC1 tumors had a worse prognosis than PPBC2 and NPBC tumors (<jats:italic>p<\/jats:italic>\u2009=\u20090.015 and <jats:italic>p<\/jats:italic>\u2009=\u20090.026, respectively). Clustering of the differentially expressed genes between the groups showed distinct expression in early PPBC (E-PPBC) tumors. Pathway analysis revealed upregulation of invasive-related pathways along with T cell exhaustion, extracellular matrix remodeling, angiogenesis, and epithelial-to-mesenchymal transition in E-PPBC tumors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Early PPBC is a unique subtype with aggressive clinical features and distinct biology. Further research is needed to accurately project the risk of recurrence and optimal treatment strategies in these young patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-023-06956-6","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T21:41:28Z","timestamp":1683754888000},"page":"139-149","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Premenopausal women with breast cancer in the early post-partum period show molecular profiles of invasion and are associated with poor prognosis"],"prefix":"10.1007","volume":"200","author":[{"given":"Vidya P.","family":"Nimbalkar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. 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