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Pre-diagnostic breastfeeding, adiposity, and mortality among parous Hispanic and non-Hispanic white women with invasive breast cancer: the Breast Cancer Health Disparities Study.
Breast Cancer Res Treat 2017; 161(2):321-331BC

Abstract

BACKGROUND

U.S. Hispanic women have high rates of parity, breastfeeding, and obesity. It is unclear whether these reproductive factors are associated with breast cancer (BC) mortality. We examined the associations between breastfeeding, parity, adiposity and BC-specific and overall mortality in Hispanic and non-Hispanic white (NHW) BC cases.

METHODS

The study population included 2921 parous women (1477 Hispanics, 1444 NHWs) from the Breast Cancer Health Disparities Study with invasive BC diagnosed between 1995 and 2004. Information on reproductive history and lifestyle factors was collected by in-person interview. Overall and stratified Cox proportional hazard regression models by ethnicity, parity, and body mass index (BMI) at age 30 years were used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS

After a median follow-up time of 11.2 years, a total of 679 deaths occurred. Pre-diagnostic breastfeeding was associated with a 16% reduction in mortality (HR 0.84; 95% 0.72-0.99) irrespective of ethnicity. Parity significantly modified the association between breastfeeding duration and mortality (p interaction = 0.05), with longer breastfeeding duration associated with lower risk among women who had ≤2 births (p trend = 0.02). Breastfeeding duration was associated with reduced risk of both BC-specific and overall mortality among women with BMI <25 kg/m2, while positive associations were observed among women with BMI ≥25 kg/m2 (p interactions <0.01).

CONCLUSION

Pre-diagnostic breastfeeding was inversely associated with risk of mortality after BC, particularly in women of low parity or normal BMI. These results provide another reason to encourage breastfeeding and weight management among young women.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Office E-6137, Baltimore, MD, 21205, USA. aconnor8@jhu.edu. Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA. aconnor8@jhu.edu.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Office E-6137, Baltimore, MD, 21205, USA. Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.Department of Biology, University of Colorado, Colorado Springs, Colorado Springs, CO, USA.Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.Cancer Prevention Institute of California, Fremont, CA, USA. Department of Health Research and Policy (Epidemiology), and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27837379

Citation

Connor, Avonne E., et al. "Pre-diagnostic Breastfeeding, Adiposity, and Mortality Among Parous Hispanic and non-Hispanic White Women With Invasive Breast Cancer: the Breast Cancer Health Disparities Study." Breast Cancer Research and Treatment, vol. 161, no. 2, 2017, pp. 321-331.
Connor AE, Visvanathan K, Baumgartner KB, et al. Pre-diagnostic breastfeeding, adiposity, and mortality among parous Hispanic and non-Hispanic white women with invasive breast cancer: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat. 2017;161(2):321-331.
Connor, A. E., Visvanathan, K., Baumgartner, K. B., Baumgartner, R. N., Boone, S. D., Hines, L. M., ... Slattery, M. L. (2017). Pre-diagnostic breastfeeding, adiposity, and mortality among parous Hispanic and non-Hispanic white women with invasive breast cancer: the Breast Cancer Health Disparities Study. Breast Cancer Research and Treatment, 161(2), pp. 321-331. doi:10.1007/s10549-016-4048-9.
Connor AE, et al. Pre-diagnostic Breastfeeding, Adiposity, and Mortality Among Parous Hispanic and non-Hispanic White Women With Invasive Breast Cancer: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat. 2017;161(2):321-331. PubMed PMID: 27837379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-diagnostic breastfeeding, adiposity, and mortality among parous Hispanic and non-Hispanic white women with invasive breast cancer: the Breast Cancer Health Disparities Study. AU - Connor,Avonne E, AU - Visvanathan,Kala, AU - Baumgartner,Kathy B, AU - Baumgartner,Richard N, AU - Boone,Stephanie D, AU - Hines,Lisa M, AU - Wolff,Roger K, AU - John,Esther M, AU - Slattery,Martha L, Y1 - 2016/11/11/ PY - 2016/10/31/received PY - 2016/11/05/accepted PY - 2016/11/12/pubmed PY - 2017/12/8/medline PY - 2016/11/13/entrez KW - Breast cancer mortality KW - Breastfeeding KW - Hispanic Americans KW - Obesity SP - 321 EP - 331 JF - Breast cancer research and treatment JO - Breast Cancer Res. Treat. VL - 161 IS - 2 N2 - BACKGROUND: U.S. Hispanic women have high rates of parity, breastfeeding, and obesity. It is unclear whether these reproductive factors are associated with breast cancer (BC) mortality. We examined the associations between breastfeeding, parity, adiposity and BC-specific and overall mortality in Hispanic and non-Hispanic white (NHW) BC cases. METHODS: The study population included 2921 parous women (1477 Hispanics, 1444 NHWs) from the Breast Cancer Health Disparities Study with invasive BC diagnosed between 1995 and 2004. Information on reproductive history and lifestyle factors was collected by in-person interview. Overall and stratified Cox proportional hazard regression models by ethnicity, parity, and body mass index (BMI) at age 30 years were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: After a median follow-up time of 11.2 years, a total of 679 deaths occurred. Pre-diagnostic breastfeeding was associated with a 16% reduction in mortality (HR 0.84; 95% 0.72-0.99) irrespective of ethnicity. Parity significantly modified the association between breastfeeding duration and mortality (p interaction = 0.05), with longer breastfeeding duration associated with lower risk among women who had ≤2 births (p trend = 0.02). Breastfeeding duration was associated with reduced risk of both BC-specific and overall mortality among women with BMI <25 kg/m2, while positive associations were observed among women with BMI ≥25 kg/m2 (p interactions <0.01). CONCLUSION: Pre-diagnostic breastfeeding was inversely associated with risk of mortality after BC, particularly in women of low parity or normal BMI. These results provide another reason to encourage breastfeeding and weight management among young women. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/27837379/Pre_diagnostic_breastfeeding_adiposity_and_mortality_among_parous_Hispanic_and_non_Hispanic_white_women_with_invasive_breast_cancer:_the_Breast_Cancer_Health_Disparities_Study_ L2 - https://doi.org/10.1007/s10549-016-4048-9 DB - PRIME DP - Unbound Medicine ER -