scholarly journals Increased Risk for Invasive Breast Cancer Associated with Hormonal Therapy: A Nation-Wide Random Sample of 65,723 Women Followed from 1997 to 2008

PLoS ONE ◽  
2011 ◽  
Vol 6 (10) ◽  
pp. e25183 ◽  
Author(s):  
Jung-Nien Lai ◽  
Chien-Tung Wu ◽  
Pau-Chung Chen ◽  
Chiun-Sheng Huang ◽  
Song-Nan Chow ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Random Sample ◽  
Hormonal Therapy ◽  
Invasive Breast Cancer ◽  
Increased Risk

scholarly journals Metabolic Syndrome and the Risk of Breast Cancer and Subtypes by Race, Menopause and BMI

Cancers ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 299 ◽  
Author(s):  
Daniel Dibaba ◽  
Dejana Braithwaite ◽  
Tomi Akinyemiju
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Invasive Breast Cancer ◽  
Ductal Carcinoma ◽  
Breast Cancer Subtype ◽  
Normal Weight ◽  
Health Study ◽  
Cancer Subtypes ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

The objective of this study was to investigate the association of metabolic syndrome (MetS) with the risk of invasive breast cancer and molecular subtypes across race, menopause, and body mass index (BMI) groups. We examined the association of metabolic syndrome and its components with risk of invasive breast cancer among 94,555 female participants of the National Institute of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, accounting for ductal carcinoma in situ as a competing risk. Cox proportional hazard regression with the Fine and Gray method was used to generate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for baseline sociodemographic, behavioral, and clinical covariates. During a mean follow-up of 14 years, 5380 (5.7%) women developed breast cancer. Overall, MetS at baseline was associated with a 13% increased risk of breast cancer compared to women without MetS (HR: 1.13, 95% CI: 1.00, 1.27); similar estimates were obtained among postmenopausal women (HR: 1.14, 95% CI: 1.01, 1.29). MetS was associated with a slight but non-significantly increased risk of breast cancer among those with both normal weight and overweight/obesity, and those with estrogen receptor positive breast cancer subtype. In the NIH-AARP cohort, MetS was associated with an increased risk of breast cancer. Further studies are needed to definitively evaluate the association of MetS with triple negative breast cancer subtypes across all levels of BMI.

scholarly journals Role of Hormones in Cancer Prevention

2014 ◽  
pp. 34-40 ◽  
Author(s):  
Victor G. Vogel
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitor ◽  
Postmenopausal Women ◽  
Invasive Breast Cancer ◽  
White Women ◽  
Risk Index ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Increased Risk

Risk for breast cancer can be easily and rapidly assessed using validated, quantitative models. Multiple randomized studies show that the selective estrogen response modifiers (SERMs) tamoxifen and raloxifene can safely reduce the risk of invasive breast cancer in both pre- and postmenopausal women. Treatment resulted in a 38% reduction in breast cancer incidence, and 42 women would need to be treated to prevent one breast cancer event in the first 10 years of follow-up. Reduction was larger in the first 5 years of follow-up than in years 5 to 10, but no studies treated patients for longer than 5 years. Thromboembolic events were significantly increased with all SERMs, whereas vertebral fractures were reduced. Tamoxifen provides net benefit to all premenopausal women who are at increased risk, whereas raloxifene reduces risk nearly as much in postmenopausal women and offers increased safety. Both tamoxifen and raloxifene reduce the incidence of in situ cancers. Lasofoxifene reduced the risk of breast cancer by 79% in postmenopausal women with osteoporosis. The MAP3 trial showed a 65% reduction in the annual incidence of invasive breast cancer in postmenopausal women who were at moderately increased risk for breast cancer who took the aromatase inhibitor exemestane. The IBIS-II trial showed a 53% reduction in the risk of invasive breast cancer in postmenopausal women aged 40 to 70 who took the aromatase inhibitor anastrozole. Of the 50 million white women in the United States aged 35 to 79, 2.4 million would have a positive benefit/risk index for chemoprevention.

Risk factors for fractures in patients on hormonal therapies for breast cancer and DCIS.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19627-e19627
Author(s):  
Abdullah Ladha ◽  
Josy Mathew
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Aromatase Inhibitors ◽  
Hormonal Therapy ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Hormonal Therapies ◽  
Positive Breast Cancer

e19627 Background: Hormonal therapy with aromatase inhibitors (AI) or tamoxifen (TAM) is standard of care for hormone receptor positive breast cancer and DCIS. Fractures are a complication of treatment with AI due to accelerated bone loss. Risk factors for fracture in patients on hormonal therapy (HT) for breast cancer and DCIS are poorly defined. Methods: All 71 patients with breast cancer or DCIS seen in the bone and mineral clinic of our institution from 2000 to 2010 were analyzed. Data on demographics, pathology, type and duration of HT, bone mineral density studies (BMD), number and site of fractures were collected. Statistical analysis: t test, chi square test and Fisher’s exact test for categorical data. Results: The age of the patients ranged 40 to 97 years. 65 patients had ER positive breast cancer, 6 patients had DCIS. 9 patients had fractures.41 patients were on an AI alone, 8 were on TAM alone and 14 were on both sequentially. Fractures involved: vertebral compression, femur, hip, distal radioulnar, rib, hand and feet bones. Patients who had osteoporosis at the femur, osteoporosis or osteopenia in the lumbar spine or forearm in the initial BMD study were found to have an increased risk of fracture (P<0.05). Patients who were on TAM and AI sequentially had an increased risk of fracture (P<0.05) compared AI alone. The use of bisphosphonates and the duration of use were significantly associated with fracture (P<0.05) as these patients already had osteoporosis. The age, race, duration of AI use and the use of calcium and vitamin D were not found to be significantly different in patients who had fractures compared to those who did not. In the 24 patients who had two BMD studies, there was no significant change in the BMD overall. Conclusions: Patients with osteoporosis or osteopenia at baseline have an increased risk of fracture with the use of hormonal therapies for breast cancer and DCIS. This risk was not eliminated by the use of bisphosphonates. Sequential use of tamoxifen and aromatase inhibitors increase the risk of fractures. Bone mineral density studies done prior to the initiation of hormonal therapy for breast cancer maybe useful estimating the risk of fracture while on treatment.

318 Immunohistochemical P53 Over-expression and Hormonal Therapy Benefit in Invasive Breast Cancer

2012 ◽  
Vol 48 ◽  
pp. S135
Author(s):  
J.W. Lee ◽  
W. Han ◽  
J. Cho ◽  
G. Gong ◽  
K.H. Jung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Invasive Breast Cancer ◽  
Over Expression

scholarly journals Circulating proteins reveal prior use of menopausal hormonal therapy and increased risk of breast cancer

2022 ◽  
Vol 17 ◽  
pp. 101339
Author(s):  
Cecilia E. Thomas ◽  
Leo Dahl ◽  
Sanna Byström ◽  
Yan Chen ◽  
Mathias Uhlén ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Increased Risk ◽  
Prior Use

scholarly journals The prognostic association of SPAG5 gene expression in breast cancer patients with systematic therapy

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chenjing Zhu ◽  
Otilia Menyhart ◽  
Balázs Győrffy ◽  
Xia He
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Roc Analysis ◽  
Survival Outcomes ◽  
Clinicopathological Factors ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Increased Risk

Abstract Background Despite much effort on the treatment of breast cancer over the decades, a great uncertainty regarding the appropriate molecular biomarkers and optimal therapeutic strategy still exists. This research was performed to analyze the association of SPAG5 gene expression with clinicopathological factors and survival outcomes. Methods We used a breast cancer database including 5667 patients with a mean follow-up of 69 months. Kaplan-Meier survival analyses for relapse free survival (RFS), overall survival (OS), and distant metastasis-free survival (DMFS) were performed. In addition, ROC analysis was performed to validate SPAG5 as a prognostic candidate gene. Results Mean SPAG5 expression value was significantly higher with some clinicopathological factors that resulted in tumor promotion and progression, including poor differentiated type, HER2 positive or TP53 mutated breast cancer. Based on ROC-analysis SPAG 5 is a suitable prognostic marker of poor survival. In patients who received chemotherapy alone, SPAG5 had only a moderate and not significant predictive impact on survival outcomes. However, in hormonal therapy, high SPAG5 expression could strongly predict prognosis with detrimental RFS (HR = 1.57, 95% CI 1.2–2.06, p = 0.001), OS (HR = 2, 95% CI 1.05–3.8, p = 0.03) and DMFS (HR = 2.36, 95% CI 1.57–3.54, p <  0.001), respectively. In addition, SPAG5 could only serve as a survival predictor in ER+, but not ER- breast cancer patients. Patients might also be at an increased risk of relapse despite being diagnosed with a lower grade cancer (well differentiated type). Conclusions SPAG5 could be used as an independent prognostic and predictive biomarker that might have clinical utility, especially in ER+ breast cancer patients who received hormonal therapy.

Effect of coronary heart disease (CHD) risk factors and medications on invasive breast cancer risk in the Raloxifene Use for The Heart (RUTH) trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1530-1530
Author(s):  
J. Mershon ◽  
M. Geiger ◽  
E. Barrett-Connor ◽  
P. Collins ◽  
M. Kornitzer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Postmenopausal Women ◽  
Invasive Breast Cancer ◽  
Chd Risk ◽  
Increased Risk ◽  
Baseline Factors ◽  
Coronary Events ◽  
Low Incidence ◽  
Chd Risk Factors

1530 Background: RUTH enrolled 10,101 postmenopausal women at increased risk for major coronary events. Women were not enrolled based on their risk for breast cancer. The incidence of invasive breast cancer in the placebo group was low for this older population of women (mean age 67.5 years). The aim of this analysis was to determine whether CHD risk factors and selected cardiac medications were protective against invasive breast cancer in this population at increased risk for coronary events. Methods: Covariates assessed were baseline factors that are known CHD risk factors and selected medications ( Table ). Univariate analyses were performed for all covariates using placebo data. Results: The effect of baseline CHD risk factors and selected cardiac medications on the incidence of invasive breast cancer in women receiving placebo in RUTH (N=5057) Conclusions: In these postmenopausal women at increased risk for major coronary events, baseline CHD risk factors and selected cardiac medications assessed individually did not protect against invasive breast cancer. The low incidence of invasive breast cancer in the RUTH population does not appear to be due to the presence of CHD risk factors or use of cardiac medications. [Table: see text] [Table: see text]

The study of tamoxifen and raloxifene (STAR): Initial findings from the NSABP P-2 breast cancer prevention study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. LBA5-LBA5 ◽  
Author(s):  
D. L. Wickerham ◽  
J. P. Costantino ◽  
V. Vogel ◽  
W. Cronin ◽  
R. Cecchini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Cardiac Events ◽  
Degree Relative ◽  
Treatment Groups ◽  
Increased Risk ◽  
History Of ◽  
The Mean

LBA5 Background: The STAR trial was designed to compare raloxifene to tamoxifen in terms of relative effect on invasive breast cancer risk and on other beneficial and detrimental outcomes associated with the use of tamoxifen. Methods: The trial opened on 7-1-1999, and accrual was completed November 4, 2004, with 19,747 women enrolled. To be eligible, a woman had to be postmenopausal with a 5-year predicted breast cancer risk of 1.66% as determined by the modified Gail model. Women were randomized and treated in a double-blinded fashion to receive 5 yr of therapy with either 20 mg per day of tamoxifen or 60 mg per day of raloxifene. The protocol-defined monitoring plan called for a final analysis and release of findings when 327 invasive breast cancer cases had been diagnosed in the total population. The mean age of the population at the time of entry into this trial was 58 yr, and the mean 5-yr risk of breast cancer was 4.04%. 93.5% of the women were white; 51.5% had a hysterectomy before entry into the study; 9.2% had a history of LCIS; 71.1% had at least one first-degree relative with a history of breast cancer. The average time on the study is 47 months. Results: There was no difference between the treatment groups in terms of effect on invasive breast cancer: 163 cases in women assigned to tamoxifen and 167 in women assigned to raloxifene (RR = 1.02, 95% CI = 0.82–1.27). The risk of invasive uterine malignancies was 40% less in the raloxifene group (36 in women assigned tamoxifen and 23 in women assigned raloxifene [RR = 0.62, 95% CI = 0.35–1.08]). The risk of non invasive breast cancer was less in the tamoxifen group (57 cases in those assigned to tamoxifen and 81 in those assigned to raloxifene [RR = 1.41, 95% CI = 1.00–2.02]). There were no significant differences between the treatment groups for any of the other invasive cancer sites or for cardiac events, osteoporotic fractures, or deaths. There were fewer thromboembolic events in women taking raloxifene than in those taking tamoxifen. Conclusions: Raloxifene is an effective alternative to tamoxifen for reducing the incidence of invasive breast cancer in postmenopausal women at increased risk of developing the disease and is associated with fewer endometrial cancers, deep vein thromboses, and pulmonary emboli. [Table: see text]

The performance of the 21-gene assay standard cutpoints of 18 and 31 in HR+, HER2- invasive breast cancer (BC), while waiting for TAILORx mid-range recurrence score results.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 537-537 ◽  
Author(s):  
Dave P. Miller ◽  
Valentina I. Petkov ◽  
Steven Shak
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Hormonal Therapy ◽  
Invasive Breast Cancer ◽  
Recurrence Score ◽  
Population Based ◽  
Additional Benefit ◽  
Gene Assay ◽  
Specific Mortality ◽  
Prior Malignancy

537 Background: The Recurrence Score (RS) was shown in NSABP B-20 to predict chemotherapy (CT) benefit for RS ≥31 and no CT benefit for RS <18. The TAILORx results for RS <11 (NEJM 2015) reported excellent outcomes with no opportunity for CT to add additional benefit. As we await TAILORx results for RS 11-25, we characterized BC specific mortality (BCSM) for RS groups (cutoffs of 11, 18, 25, and 31) in the population-based SEER study of pts treated based on RS. Methods: RS results were provided to SEER registries per their methods (npj Breast Cancer 2016). Pts diagnosed (Jan 2004 - Dec 2012) with N0 HR+ HER2- negative BC, and no prior malignancy were eligible. BCSM estimates by CT use were computed using standard cutpoints of 18 and 31 and TAILORx cutpoints of 11 and 25. Results: Among 49,681 with a RS, 9,486 (19%) had RS <11, 17,988 (36%) had RS 11-17, 14,541 (29%) had RS 18-25, 3,805 (8%) had RS 26-30, and 3,861 (8%) had RS ≥31. Reported CT use and 5-y BCSM increased with increasing RS. For pts with both RS <11 and RS 11-17, CT use was uncommon and 5-y BCSM was low regardless of CT use. For pts with RS 18-25, CT use was more common and the 5-y BCSM was about 1% regardless of CT use. For pts with RS of 26-30 or ≥31, CT was common, and lower 5-y BCSM was observed with CT reported yes than with CT reported no or unknown. Conclusions: Pts in real-world clinical practice with RS <11, consistent with TAILORx, and pts with RS 11-17 have low 5-y BCSM with limited CT use, supporting hormonal therapy alone for pts with RS <18. The high end of the TAILORx mid-range (18-25) also showed good 5-y BCSM both with and without CT, highlighting the importance of the randomized results of TAILORx. [Table: see text]

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