Learning From Temporal Relationships: Childbirth and Breast Cancer Risk
Authors: Katrina Armstrong
Journal: Annals of Internal Medicine (2018)

Editorials1 January 2019Learning From Temporal Relationships: Childbirth and Breast Cancer RiskKatrina Armstrong, MD, MSCEKatrina Armstrong, MD, MSCEMassachusetts General Hospital, Boston, Massachusetts (K.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3455 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The relationship between childbirth and breast cancer risk is complex. Childbirth is an intrinsically multidimensional “exposure,” and understanding its effects requires disentangling age, parity, use of contraceptive and reproductive technology, and breastfeeding, among other factors. Given this complexity, the results of the large and sophisticated analysis by Nichols and colleagues (1) provide an important advance in this field. In this examination of nearly 900 000 women aged younger than 55 years who were enrolled in studies of premenopausal breast cancer, risk for breast cancer peaked 5 years after childbirth and then gradually decreased for at least 2 decades. Because of the ...References1. Nichols HB, Schoemaker MJ, Cai J, Xu J, Wright LB, Brook MN, et al. Breast cancer risk after recent childbirth. A pooled analysis of 15 prospective studies. Ann Intern Med. 2019;170:22-30. doi:10.7326/M18-1323 LinkGoogle Scholar2. Lambe M, Hsieh C, Trichopoulos D, Ekbom A, Pavia M, Adami HO. Transient increase in the risk of breast cancer after giving birth. N Engl J Med. 1994;331:5-9. [PMID: 8202106] CrossrefMedlineGoogle Scholar3. Janerich DT, Hoff MB. Evidence for a crossover in breast cancer risk factors. Am J Epidemiol. 1982;116:737-42. [PMID: 6756128] CrossrefMedlineGoogle Scholar4. Rotunno M, Sun X, Figueroa J, Sherman ME, Garcia-Closas M, Meltzer P, et al. 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Evidence for the cost of reproduction in humans: high lifetime reproductive effort is associated with greater oxidative stress in post-menopausal women. PLoS One. 2016;11:e0145753. [PMID: 26761206] doi:10.1371/journal.pone.0145753 CrossrefMedlineGoogle Scholar9. Ryan CP, Hayes MG, Lee NR, McDade TW, Jones MJ, Kobor MS, et al. Reproduction predicts shorter telomeres and epigenetic age acceleration among young adult women. Sci Rep. 2018;8:11100. [PMID: 30038336] doi:10.1038/s41598-018-29486-4 CrossrefMedlineGoogle Scholar10. Lathrop AE, Loeb L. Further investigations on the origin of tumors in mice. III. On the part played by internal secretion in the spontaneous development of tumors. J Cancer Res. 1916;1:1-19. [PMID: 12264098] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, Massachusetts (K.A.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3455.Corresponding Author: Katrina Armstrong, MD, MSCE, Department of Medicine, Massachusetts General Hospital, Grey/Bigelow 7th Floor, 55 Fruit Street, Boston, MA 02114; e-mail, [email protected]harvard.edu.This article was published at Annals.org on 11 December 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBreast Cancer Risk After Recent Childbirth Hazel B. Nichols , Minouk J. Schoemaker , Jianwen Cai , Jiawei Xu , Lauren B. Wright , Mark N. Brook , Michael E. Jones , Hans-Olov Adami , Laura Baglietto , Kimberly A. Bertrand , William J. Blot , Marie-Christine Boutron-Ruault , Miren Dorronsoro , Laure Dossus , A. Heather Eliassen , Graham G. Giles , Inger T. Gram , Susan E. Hankinson , Judy Hoffman-Bolton , Rudolf Kaaks , Timothy J. Key , Cari M. Kitahara , Susanna C. Larsson , Martha Linet , Melissa A. Merritt , Roger L. Milne , Valeria Pala , Julie R. Palmer , Petra H. Peeters , Elio Riboli , Malin Sund , Rulla M. Tamimi , Anne Tjønneland , Antonia Trichopoulou , Giske Ursin , Lars Vatten , Kala Visvanathan , Elisabete Weiderpass , Alicja Wolk , Wei Zheng , Clarice R. Weinberg , Anthony J. Swerdlow , and Dale P. Sandler Metrics 1 January 2019Volume 170, Issue 1Page: 66-67KeywordsBirthBreast cancerCancer risk factorsHospital medicineMammographyObservational studiesRandomized trialsRisk managementSurgeryWeight gain ePublished: 11 December 2018 Issue Published: 1 January 2019 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...