{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:47:31Z","timestamp":1779889651532,"version":"3.53.1"},"reference-count":23,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2004,2,15]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> The time interval between last childbirth and subsequent breast cancer diagnosis is emerging as an important prognostic factor for premenopausal women. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We studied, prospectively, 750 women diagnosed with primary invasive breast cancer before age 45 years who participated in the population-based Australian Breast Cancer Family Study (ABCFS). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Median follow-up time was 4.9 years (range, 0.8 to 10.8 years). Compared with nulliparous women, women who gave birth within 2 years prior to diagnosis were more likely to have axillary node-positive (58% v 41%; P = .01), and estrogen receptor-negative (58% v 39%; P = .005) tumors. The unadjusted hazard ratios for death were 2.3 (95% CI, 1.3 to 3.8; P = .002), 1.7 (95% CI, 1.1 to 2.6; P = .03), and 0.9 (95% CI, 0.6 to 1.5; P = .8) for patients who gave birth less than 2 years, 2 to 5 years, and 5 or more years before diagnosis, respectively. After adjusting for tumor characteristics, these hazard ratios were reduced to 1.9 (95%CI, 1.1 to 3.2; P = .02), 1.3 (95% CI, 0.8 to 2.1; P = .3), and 0.9 (95%CI, 0.5 to 1.4; P = .5). Modeling showed that, compared with nulliparous women, the mortality hazard ratio in parous women was 1.9, decreasing by 8% (95%CI, 4% to 13%; P &lt; .001) for each year between last birth and breast cancer diagnosis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Proximity of last childbirth to subsequent breast cancer diagnosis is a predictor of mortality independent of histopathological tumor characteristics. Clinicians should be aware that women diagnosed with breast cancer within a few years following childbirth may have a worse outcome than that suggested solely by the standard histopathological prognostic factors of their cancer. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2004.07.062","type":"journal-article","created":{"date-parts":[[2004,2,14]],"date-time":"2004-02-14T02:18:29Z","timestamp":1076725109000},"page":"699-705","source":"Crossref","is-referenced-by-count":58,"title":["Prognosis of Premenopausal Breast Cancer and Childbirth Prior to Diagnosis"],"prefix":"10.1200","volume":"22","author":[{"given":"Kelly-Anne","family":"Phillips","sequence":"first","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L.","family":"Milne","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Friedlander","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret R.E.","family":"McCredie","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham G.","family":"Giles","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Hopper","sequence":"additional","affiliation":[{"name":"From the Peter MacCallum Cancer Centre, The University of Melbourne, and The Cancer Council Victoria, Victoria, Australia; Prince of Wales Hospital, New South Wales, Australia; and University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.2820710413"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6656.1096"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199407073310102"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1995.359"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1007\/BF00051403"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008886328352"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1007\/BF01805718"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(88)90056-4"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)93054-6"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7112.851"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Olson SH, Zauber AG, Tang J, et al: Relation of time since last birth and parity to survival of young women with breast cancer. 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