Estrogen receptor status in relation to risk of contralateral breast cancer-a population-based cohort study
(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.
(Less)
- author
- Sandberg, Maria E C LU ; Hall, Per ; Hartman, Mikael ; Johansson, Anna L V ; Eloranta, Sandra ; Ploner, Alexander and Czene, Kamila
- publishing date
- 2012
- type
- Contribution to journal
- 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
- article number
- e46535
- publisher
- Public Library of Science (PLoS)
- external identifiers
-
- scopus:84867307921
- pmid:23056335
- 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
- 2024-03-17 22:52:21
@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>}},
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}},
keywords = {{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 (PLoS)}},
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}},
doi = {{10.1371/journal.pone.0046535}},
volume = {{7}},
year = {{2012}},
}