Mortality up for breast cancer diagnosed five to 10 years after childbirth

Young-onset breast cancer (YOBC) with germline BRCA pathogenic variants (PVs) is associated with an increased risk for all-cause mortality if diagnosed within 10 years after childbirth, according to a study published online April 19 in JAMA Network Open.

Zhenzhen Zhang, Ph.D., M.P.H., from the Oregon Health & Science University in Portland, and colleagues examined whether time between most recent childbirth and BC diagnosis is associated with mortality among patients with YOBC and germline BRCA1/2 PVs in a prospective cohort study. Data were included for 903 women with BRCA PVs diagnosed with stage I to III BC at age 45 years or younger.

Of the participants, 419 received a BC diagnosis zero to less than 10 years after childbirth, including 228 and 191 who were diagnosed less than five years after childbirth and five to less than 10 years after childbirth, respectively. Compared with nulliparous women and women diagnosed 10 or more years after childbirth, women diagnosed within five to less than 10 years after childbirth had increased all-cause mortality (hazard ratio, 1.56).

Compared with the nulliparous group, the risk for mortality was greater for women with estrogen-receptor (ER)-positive BC in the group that was less than five years postpartum and for women with ER-negative BC in the group that was five to less than 10 years postpartum (hazard ratios, 2.35 and 3.12, respectively).

"Consideration of the potential impact of childbirth on BC outcomes in young germline BRCA PV carriers may improve standard of care within the realms of genetic counseling, disease prevention, and the clinic," the authors write.

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