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Prognostic implications of estrogen receptor pattern of both tumors in contralateral breast cancer

Sandberg, Maria E. C. LU ; Hartman, Mikael; Klevebring, Daniel; Eloranta, Sandra; Ploner, Alexander; Hall, Per and Czene, Kamila (2012) In Breast Cancer Research and Treatment 134(2). p.793-800
Abstract

Estrogen receptor (ER) status is important for breast cancer survival, it is however unclear how prognosis of contralateral breast cancer (CBC) is affected by ER-status of the two tumors. We conducted a large, population-based study of ER-status of both tumors in CBC patients and its influence on prognosis. The cohort consisted of all women diagnosed with CBC in Stockholm, Sweden during 1976-2005, with information on ER-status from medical records (N = 933). Prognosis was modeled as incidence rates of distant metastasis via Poisson regression. The proportion of CBCs with both cancers of the same ER-status was significantly larger than expected by chance. For synchronous (simultaneous) cancers the prognosis was significantly affected by... (More)

Estrogen receptor (ER) status is important for breast cancer survival, it is however unclear how prognosis of contralateral breast cancer (CBC) is affected by ER-status of the two tumors. We conducted a large, population-based study of ER-status of both tumors in CBC patients and its influence on prognosis. The cohort consisted of all women diagnosed with CBC in Stockholm, Sweden during 1976-2005, with information on ER-status from medical records (N = 933). Prognosis was modeled as incidence rates of distant metastasis via Poisson regression. The proportion of CBCs with both cancers of the same ER-status was significantly larger than expected by chance. For synchronous (simultaneous) cancers the prognosis was significantly affected by the combined ER-status of both tumors (p = 0.01). Compared to unilateral breast cancer patients the incidence rate ratio (IRR) for patients with double ER-positive tumors was 1.25 (95 % CI: 0.88-1.76), for ER-discordant tumors 2.19 (95 % CI: 1.18-4.08) and for double ER-negative tumors 3.95 (95 % CI: 1.77-8.81). For metachronous (non-simultaneous) cancers, women with double ER-positive tumors had similarly bad prognosis (IRR = 2.95; 95 % CI: 2.39-3.64) as women with double ER-negative tumors (IRR = 2.88; 95 % CI: 1.83-4.52). Both shorter time span between first and second cancer and endocrine therapy for the first cancer further worsened prognosis of women with double ER-positive metachronous CBC. For synchronous CBC patients, ER-pattern of both tumors is an important prognosticator, while among metachronous CBC patients, double ER-positive tumors confer equally bad prognosis as double ER-negative cancers. Our results indicate that this might be due to endocrine therapy resistance.

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published
keywords
Aged, Breast Neoplasms, Cohort Studies, Female, Humans, Incidence, Middle Aged, Neoplasm Metastasis, Neoplasms, Multiple Primary, Neoplasms, Second Primary, Poisson Distribution, Prognosis, Receptors, Estrogen, Regression Analysis, Journal Article, Research Support, Non-U.S. Gov't
in
Breast Cancer Research and Treatment
volume
134
issue
2
pages
8 pages
publisher
Springer
external identifiers
  • scopus:84867292266
ISSN
1573-7217
DOI
10.1007/s10549-012-2096-3
language
English
LU publication?
no
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93a524b1-279b-4804-9fd5-3ebcf35ee8e5
date added to LUP
2017-10-16 08:56:04
date last changed
2017-10-22 05:37:00
@article{93a524b1-279b-4804-9fd5-3ebcf35ee8e5,
  abstract     = {<p>Estrogen receptor (ER) status is important for breast cancer survival, it is however unclear how prognosis of contralateral breast cancer (CBC) is affected by ER-status of the two tumors. We conducted a large, population-based study of ER-status of both tumors in CBC patients and its influence on prognosis. The cohort consisted of all women diagnosed with CBC in Stockholm, Sweden during 1976-2005, with information on ER-status from medical records (N = 933). Prognosis was modeled as incidence rates of distant metastasis via Poisson regression. The proportion of CBCs with both cancers of the same ER-status was significantly larger than expected by chance. For synchronous (simultaneous) cancers the prognosis was significantly affected by the combined ER-status of both tumors (p = 0.01). Compared to unilateral breast cancer patients the incidence rate ratio (IRR) for patients with double ER-positive tumors was 1.25 (95 % CI: 0.88-1.76), for ER-discordant tumors 2.19 (95 % CI: 1.18-4.08) and for double ER-negative tumors 3.95 (95 % CI: 1.77-8.81). For metachronous (non-simultaneous) cancers, women with double ER-positive tumors had similarly bad prognosis (IRR = 2.95; 95 % CI: 2.39-3.64) as women with double ER-negative tumors (IRR = 2.88; 95 % CI: 1.83-4.52). Both shorter time span between first and second cancer and endocrine therapy for the first cancer further worsened prognosis of women with double ER-positive metachronous CBC. For synchronous CBC patients, ER-pattern of both tumors is an important prognosticator, while among metachronous CBC patients, double ER-positive tumors confer equally bad prognosis as double ER-negative cancers. Our results indicate that this might be due to endocrine therapy resistance.</p>},
  author       = {Sandberg, Maria E. C. and Hartman, Mikael and Klevebring, Daniel and Eloranta, Sandra and Ploner, Alexander and Hall, Per and Czene, Kamila},
  issn         = {1573-7217},
  keyword      = {Aged,Breast Neoplasms,Cohort Studies,Female,Humans,Incidence,Middle Aged,Neoplasm Metastasis,Neoplasms, Multiple Primary,Neoplasms, Second Primary,Poisson Distribution,Prognosis,Receptors, Estrogen,Regression Analysis,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {2},
  pages        = {793--800},
  publisher    = {Springer},
  series       = {Breast Cancer Research and Treatment},
  title        = {Prognostic implications of estrogen receptor pattern of both tumors in contralateral breast cancer},
  url          = {http://dx.doi.org/10.1007/s10549-012-2096-3},
  volume       = {134},
  year         = {2012},
}