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Reproductive history can impact breast cancer prognosis and outcomes. Later-life births and having several children is associated with lower survival rates, so regular breast cancer screenings must be emphasized in pregnant women. 

Women in low- and middle-income countries are beginning to have fewer children and delaying their first pregnancy. Meanwhile, breast cancer incidence continues to rise. Scientists are attempting to understand how reproductive behaviors may be influencing the rise in breast cancer in these areas. 

Scientists at the World Health Organization (WHO) performed a study involving patients in Sub-Saharan Africa (SSA) to determine how pregnancy and fertility patterns influence breast cancer prognosis. Among mothers in SSA, the number of children carried to term varies greatly, and more mothers are receiving breast cancer diagnoses after a recent birth. These reproductive and diagnostic trends of SSA can help epidemiologists identify prognostic factors of breast cancer and determine potential interventions. 

Data from the African Breast Cancer–Disparities in Outcomes (ABC-DO) cohort provided the reproductive histories of breast cancer patients born between 1945 and 1975. They found that women who carried at least five pregnancies to term before their cancer diagnosis had marginally lower survival rates at five years. Mortality was substantially higher in women who had given birth within the last three years and in older mothers. Poorer outcomes due to recent pregnancy may be attributable to pregnancy-related hormones promoting the growth of fast-growing tumors. 

In SSA, almost one-third of pre-menopausal breast cancer patients have recently given birth, which increases their risk for delayed diagnosis and more aggressive tumors. Although women are now having fewer children, the risk of breast cancer in older recent mothers is forthcoming. The WHO’s Global Breast Care Initiative is supporting programs aimed at improving diagnosis of breast cancer in recently pregnant women to improve their long-term outcomes.

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Boucheron, P., Anele, A., Offiah, A. U., Zietsman, A., Galukande, M., Parham, G., Pinder, L. F., Anderson, B. O., Foerster, M., Schüz, J., dos SantosSilva, I., & McCormack, V. (2023). Reproductive history and breast cancer survival: Findings from the African breast cancer—disparities in outcomes cohort and implications of Africa’s fertility transition on breast cancer prognosis. International Journal of Cancer. https://doi.org/10.1002/ijc.34411