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Estrogen receptor status in relation to risk of contralateral breast cancer-a population-based cohort study

Sandberg, Maria E C LU ; Hall, Per; Hartman, Mikael; Johansson, Anna L V; Eloranta, Sandra; Ploner, Alexander and Czene, Kamila (2012) In PLoS ONE 7(10).
Abstract

BACKGROUND: It is unclear whether estrogen receptor (ER)-status of first primary breast cancer is associated with risk of metachronous (non-simultaneous) contralateral breast cancer (CBC), and to what extent endocrine therapy affects this association.

METHODS: We studied the effect of ER-status of the first cancer on the risk of CBC overall, and for different ER-subtypes of CBC, using a large, population-based cohort. The cohort consisted of all women diagnosed with breast cancer in the Stockholm region 1976-2005; 25715 patients, of whom 940 suffered CBC. The relative risk was analyzed mainly using standardized incidence ratios (SIR).

RESULTS: Women with breast cancer had a doubled risk of CBC compared to the risk of breast... (More)

BACKGROUND: It is unclear whether estrogen receptor (ER)-status of first primary breast cancer is associated with risk of metachronous (non-simultaneous) contralateral breast cancer (CBC), and to what extent endocrine therapy affects this association.

METHODS: We studied the effect of ER-status of the first cancer on the risk of CBC overall, and for different ER-subtypes of CBC, using a large, population-based cohort. The cohort consisted of all women diagnosed with breast cancer in the Stockholm region 1976-2005; 25715 patients, of whom 940 suffered CBC. The relative risk was analyzed mainly using standardized incidence ratios (SIR).

RESULTS: Women with breast cancer had a doubled risk of CBC compared to the risk of breast cancer in the general female population (SIR: 2.22 [2.08-2.36]), for women with a previous ER-positive cancer: SIR=2.30 (95% CI:2.11-2.50) and for women with a previous ER-negative cancer: SIR=2.17 (95% CI:1.82-2.55). The relative risk of ER-positive and ER-negative CBC was very similar for women with ER-positive first cancer (SIR=2.02 [95%CI: 1.80-2.27] and SIR=1.89 [95%CI: 1.46-2.41] respectively) while for patients with ER-negative first cancer the relative risk was significantly different (SIR=1.27 [95% CI:0.94-1.68] for ER-positive CBC and SIR=4.96 [95%CI:3.67-6.56] for ER-negative CBC). Patients with ER-positive first cancer who received hormone therapy still had a significantly higher risk of CBC than the risk of breast cancer for the general female population (SIR=1.74 [95% CI:1.47-2.03]).

CONCLUSION: The risk of CBC for a breast cancer patient is increased to about two-fold, compared to the risk of breast cancer in the general female population. This excess risk decreases, but does not disappear, with adjuvant endocrine therapy. Patients with ER-positive first cancers have an increased risk for CBC of both ER subtypes, while patients with ER-negative first cancer have a specifically increased risk of ER-negative CBC.

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publication status
published
keywords
Aged, Breast Neoplasms, Cohort Studies, Female, Humans, Middle Aged, Population Surveillance, Journal Article, Research Support, Non-U.S. Gov't
in
PLoS ONE
volume
7
issue
10
publisher
Public Library of Science
external identifiers
  • scopus:84867307921
ISSN
1932-6203
DOI
10.1371/journal.pone.0046535
language
English
LU publication?
no
id
e915c6ab-f024-4369-a39c-d3675651e83f
date added to LUP
2017-10-16 08:56:54
date last changed
2017-10-22 05:37:00
@article{e915c6ab-f024-4369-a39c-d3675651e83f,
  abstract     = {<p>BACKGROUND: It is unclear whether estrogen receptor (ER)-status of first primary breast cancer is associated with risk of metachronous (non-simultaneous) contralateral breast cancer (CBC), and to what extent endocrine therapy affects this association.</p><p>METHODS: We studied the effect of ER-status of the first cancer on the risk of CBC overall, and for different ER-subtypes of CBC, using a large, population-based cohort. The cohort consisted of all women diagnosed with breast cancer in the Stockholm region 1976-2005; 25715 patients, of whom 940 suffered CBC. The relative risk was analyzed mainly using standardized incidence ratios (SIR).</p><p>RESULTS: Women with breast cancer had a doubled risk of CBC compared to the risk of breast cancer in the general female population (SIR: 2.22 [2.08-2.36]), for women with a previous ER-positive cancer: SIR=2.30 (95% CI:2.11-2.50) and for women with a previous ER-negative cancer: SIR=2.17 (95% CI:1.82-2.55). The relative risk of ER-positive and ER-negative CBC was very similar for women with ER-positive first cancer (SIR=2.02 [95%CI: 1.80-2.27] and SIR=1.89 [95%CI: 1.46-2.41] respectively) while for patients with ER-negative first cancer the relative risk was significantly different (SIR=1.27 [95% CI:0.94-1.68] for ER-positive CBC and SIR=4.96 [95%CI:3.67-6.56] for ER-negative CBC). Patients with ER-positive first cancer who received hormone therapy still had a significantly higher risk of CBC than the risk of breast cancer for the general female population (SIR=1.74 [95% CI:1.47-2.03]).</p><p>CONCLUSION: The risk of CBC for a breast cancer patient is increased to about two-fold, compared to the risk of breast cancer in the general female population. This excess risk decreases, but does not disappear, with adjuvant endocrine therapy. Patients with ER-positive first cancers have an increased risk for CBC of both ER subtypes, while patients with ER-negative first cancer have a specifically increased risk of ER-negative CBC.</p>},
  articleno    = {e46535},
  author       = {Sandberg, Maria E C and Hall, Per and Hartman, Mikael and Johansson, Anna L V and Eloranta, Sandra and Ploner, Alexander and Czene, Kamila},
  issn         = {1932-6203},
  keyword      = {Aged,Breast Neoplasms,Cohort Studies,Female,Humans,Middle Aged,Population Surveillance,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {10},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Estrogen receptor status in relation to risk of contralateral breast cancer-a population-based cohort study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0046535},
  volume       = {7},
  year         = {2012},
}