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Prognostic Impact of Menopausal Hormone Therapy in Breast Cancer Differs According to Tumor Characteristics and Treatment

Godina, Christopher LU orcid ; Ottander, Erik ; Tryggvadottir, Helga LU ; Borgquist, Signe LU ; Isaksson, Karolin LU and Jernström, Helena LU (2020) In Frontiers in Oncology 10.
Abstract

This study investigated how a history of menopausal hormone therapy (MHT) impacts clinical outcomes overall and in different subgroups of breast cancer patients. The study included 814 primary breast cancer patients aged ≥50 years in Sweden (2002–2012) with follow-up until 2016. Associations between patient- and tumor characteristics, recurrences, and overall survival were analyzed in relation to MHT. After a median follow-up of 7 years, 119 recurrences, and 111 deaths occurred. Ever MHT (n = 433, 53.2%) was associated with a lower BMI, frequency of alcohol abstinence, and histological grade, higher frequency of oral contraceptive use, and lobular cancer. Overall, MHT was not associated with prognosis, but there were significant effect... (More)

This study investigated how a history of menopausal hormone therapy (MHT) impacts clinical outcomes overall and in different subgroups of breast cancer patients. The study included 814 primary breast cancer patients aged ≥50 years in Sweden (2002–2012) with follow-up until 2016. Associations between patient- and tumor characteristics, recurrences, and overall survival were analyzed in relation to MHT. After a median follow-up of 7 years, 119 recurrences, and 111 deaths occurred. Ever MHT (n = 433, 53.2%) was associated with a lower BMI, frequency of alcohol abstinence, and histological grade, higher frequency of oral contraceptive use, and lobular cancer. Overall, MHT was not associated with prognosis, but there were significant effect modifications by estrogen receptor (ER) status, node status, main histological type, and aromatase inhibitor (AI) treatment on recurrence-risk (all Pinteractions≤ 0.017). MHT conferred an increased recurrence-risk in patients with ER- tumors, adjusted Hazard Ratio (HRadj) 3.99 (95% Confidence Interval (CI) 1.40–11.33), in node-negative patients HRadj 1.88 (95% CI 1.11–3.17), and in non-AI-treated patients HRadj 1.81 (95% CI 1.01–3.24), but decreased recurrence-risk in AI-treated patients HRadj 0.46 (95% CI 0.25–0.84) and in patients with lobular cancer HRadj 0.15 (95% CI 0.04–0.64). MHT was associated with lower risk of death in node-positive patients HRadj of 0.48 (95% CI 0.27–0.86) and in AI-treated patients HRadj of 0.41 (95% CI 0.22–0.77), but not in other patients (both Pinteractions≤ 0.027). A history of MHT may have prognostic value for certain subgroups of breast cancer patients such as AI-treated or node-negative patients.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aromatase inhibitor, breast cancer, cohort, menopausal hormone therapy, prognosis
in
Frontiers in Oncology
volume
10
article number
80
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85079640025
  • pmid:32117735
ISSN
2234-943X
DOI
10.3389/fonc.2020.00080
language
English
LU publication?
yes
id
bf1a4bd1-0689-4ea5-8277-2be782ccdbb6
date added to LUP
2020-03-10 11:27:57
date last changed
2024-03-04 14:52:24
@article{bf1a4bd1-0689-4ea5-8277-2be782ccdbb6,
  abstract     = {{<p>This study investigated how a history of menopausal hormone therapy (MHT) impacts clinical outcomes overall and in different subgroups of breast cancer patients. The study included 814 primary breast cancer patients aged ≥50 years in Sweden (2002–2012) with follow-up until 2016. Associations between patient- and tumor characteristics, recurrences, and overall survival were analyzed in relation to MHT. After a median follow-up of 7 years, 119 recurrences, and 111 deaths occurred. Ever MHT (n = 433, 53.2%) was associated with a lower BMI, frequency of alcohol abstinence, and histological grade, higher frequency of oral contraceptive use, and lobular cancer. Overall, MHT was not associated with prognosis, but there were significant effect modifications by estrogen receptor (ER) status, node status, main histological type, and aromatase inhibitor (AI) treatment on recurrence-risk (all P<sub>interactions</sub>≤ 0.017). MHT conferred an increased recurrence-risk in patients with ER- tumors, adjusted Hazard Ratio (HR<sub>adj</sub>) 3.99 (95% Confidence Interval (CI) 1.40–11.33), in node-negative patients HR<sub>adj</sub> 1.88 (95% CI 1.11–3.17), and in non-AI-treated patients HR<sub>adj</sub> 1.81 (95% CI 1.01–3.24), but decreased recurrence-risk in AI-treated patients HR<sub>adj</sub> 0.46 (95% CI 0.25–0.84) and in patients with lobular cancer HR<sub>adj</sub> 0.15 (95% CI 0.04–0.64). MHT was associated with lower risk of death in node-positive patients HR<sub>adj</sub> of 0.48 (95% CI 0.27–0.86) and in AI-treated patients HR<sub>adj</sub> of 0.41 (95% CI 0.22–0.77), but not in other patients (both P<sub>interactions</sub>≤ 0.027). A history of MHT may have prognostic value for certain subgroups of breast cancer patients such as AI-treated or node-negative patients.</p>}},
  author       = {{Godina, Christopher and Ottander, Erik and Tryggvadottir, Helga and Borgquist, Signe and Isaksson, Karolin and Jernström, Helena}},
  issn         = {{2234-943X}},
  keywords     = {{aromatase inhibitor; breast cancer; cohort; menopausal hormone therapy; prognosis}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Oncology}},
  title        = {{Prognostic Impact of Menopausal Hormone Therapy in Breast Cancer Differs According to Tumor Characteristics and Treatment}},
  url          = {{http://dx.doi.org/10.3389/fonc.2020.00080}},
  doi          = {{10.3389/fonc.2020.00080}},
  volume       = {{10}},
  year         = {{2020}},
}