Risk of breast cancer among patients with bioprosthetic or mechanical valve replacement: a population-based study in Sweden.
Ji, Jianguang LU
; Zöller, Bengt
LU
; Giaccia, Amato
; Haile, Robert
; Sundquist, Jan
LU
and Sundquist, Kristina
LU
(2015)
In Breast Cancer Research and Treatment
154(2).
p.369-375
- Abstract
- The association between breast cancer and warfarin is inconclusive as most previous studies examined their association using patients with thromboembolism, whereas thromboembolism itself is a risk factor for cancer. We explored this issue using patients received mechanical heart valves replacement as a proxy for warfarin exposure as these patients need a lifelong warfarin treatment, and compared them with patients received bioprosthesis valves replacement (short-term warfarin treatment) in Sweden between 1987 and 2010. Patients who were operated on for valve replacement were identified from the Swedish Hospital Discharge Registry and linked to the Swedish Cancer Registry to examine the hazard ratios of subsequent breast cancer. A total of... (More)
- The association between breast cancer and warfarin is inconclusive as most previous studies examined their association using patients with thromboembolism, whereas thromboembolism itself is a risk factor for cancer. We explored this issue using patients received mechanical heart valves replacement as a proxy for warfarin exposure as these patients need a lifelong warfarin treatment, and compared them with patients received bioprosthesis valves replacement (short-term warfarin treatment) in Sweden between 1987 and 2010. Patients who were operated on for valve replacement were identified from the Swedish Hospital Discharge Registry and linked to the Swedish Cancer Registry to examine the hazard ratios of subsequent breast cancer. A total of 12,242 women were operated on for valve replacement (5481 with mechanical valve and 6401 with bioprosthetic valve). For the entire cohort, the HR of breast cancer was 1.49 (95 % CI 1.09-2.02) among patients with mechanical valve replacement compared to those with bioprosthetic valve replacement. After controlling for a number of confounding factors using propensity score weighting, the HR was 1.69 (95 % CI 1.15-2.47). Our study found that patients with mechanical valve replacement have an increased risk of breast cancer compared to those with bioprosthetic valve replacement. If confirmed, this increased risk should be considered when recommending breast cancer screening for women with mechanical valve replacement. Long-term use of warfarin may explain the observed increase. If so, patients who have used warfarin long-term for other reasons should be studied for a possible increased risk of breast cancer. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/8149097
- author
- Ji, Jianguang
LU
; Zöller, Bengt
LU
; Giaccia, Amato
; Haile, Robert
; Sundquist, Jan
LU
and Sundquist, Kristina
LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Breast Cancer Research and Treatment
- volume
- 154
- issue
- 2
- pages
- 369 - 375
- publisher
- Springer
- external identifiers
-
- pmid:26476725
- wos:000365188600015
- scopus:84947489596
- pmid:26476725
- ISSN
- 1573-7217
- DOI
- 10.1007/s10549-015-3607-9
- language
- English
- LU publication?
- yes
- id
- 64c45c68-7033-4607-a976-4d5911956d43 (old id 8149097)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/26476725?dopt=Abstract
- date added to LUP
- 2016-04-01 10:50:44
- date last changed
- 2022-01-26 03:00:57
@article{64c45c68-7033-4607-a976-4d5911956d43,
abstract = {{The association between breast cancer and warfarin is inconclusive as most previous studies examined their association using patients with thromboembolism, whereas thromboembolism itself is a risk factor for cancer. We explored this issue using patients received mechanical heart valves replacement as a proxy for warfarin exposure as these patients need a lifelong warfarin treatment, and compared them with patients received bioprosthesis valves replacement (short-term warfarin treatment) in Sweden between 1987 and 2010. Patients who were operated on for valve replacement were identified from the Swedish Hospital Discharge Registry and linked to the Swedish Cancer Registry to examine the hazard ratios of subsequent breast cancer. A total of 12,242 women were operated on for valve replacement (5481 with mechanical valve and 6401 with bioprosthetic valve). For the entire cohort, the HR of breast cancer was 1.49 (95 % CI 1.09-2.02) among patients with mechanical valve replacement compared to those with bioprosthetic valve replacement. After controlling for a number of confounding factors using propensity score weighting, the HR was 1.69 (95 % CI 1.15-2.47). Our study found that patients with mechanical valve replacement have an increased risk of breast cancer compared to those with bioprosthetic valve replacement. If confirmed, this increased risk should be considered when recommending breast cancer screening for women with mechanical valve replacement. Long-term use of warfarin may explain the observed increase. If so, patients who have used warfarin long-term for other reasons should be studied for a possible increased risk of breast cancer.}},
author = {{Ji, Jianguang and Zöller, Bengt and Giaccia, Amato and Haile, Robert and Sundquist, Jan and Sundquist, Kristina}},
issn = {{1573-7217}},
language = {{eng}},
number = {{2}},
pages = {{369--375}},
publisher = {{Springer}},
series = {{Breast Cancer Research and Treatment}},
title = {{Risk of breast cancer among patients with bioprosthetic or mechanical valve replacement: a population-based study in Sweden.}},
url = {{http://dx.doi.org/10.1007/s10549-015-3607-9}},
doi = {{10.1007/s10549-015-3607-9}},
volume = {{154}},
year = {{2015}},
}