Use of Non-Cancer Medications in New Zealand Women at the Diagnosis of Primary Invasive Breast Cancer: Prevalence, Associated Factors and Effects on Survival

Background: Assessing the use of multiple medications in cancer patients is crucial as such use may affect cancer outcomes. This study reports the prevalence of non-cancer medication use at breast cancer diagnosis, its associated factors, and its effect on survival. Methods: We identified all women diagnosed with primary invasive breast cancer between 1 January 2007 and 31 December 2016, from four population-based breast cancer registries, in Auckland, Waikato, Wellington, and Christchurch, New Zealand. Through linkage to the pharmaceutical records, we obtained information on non-cancer medications that were dispensed for a minimum of 90 days’ supply between one year before cancer diagnosis and first cancer treatment. We performed ordered logistic regressions to identify associated factors and Cox regressions to investigate its effect on patient survival. Results: Of 14,485 patients, 52% were dispensed at least one drug (mean—1.3 drugs; maximum—13 drugs), with a higher prevalence observed in patients who were older, treated at a public facility, more economically deprived, and screen-detected. The use of 2–3 drugs showed a reduced non-breast cancer mortality (HR = 0.75, 95%CI = 0.60–0.92) in previously hospitalised patients, with other groups showing non-significant associations when adjusted for confounding factors. Drug use was not associated with changes in breast cancer-specific mortality. Conclusions: Non-cancer medication use at breast cancer diagnosis was common in New Zealand, more prevalent in older and disadvantaged women, and showed no effect on breast cancer-specific mortality, but a reduction in other cause mortality with the use of 2–3 drugs.

Clinicopathological significance of Sox10 expression in triple-negative breast carcinoma

Purpose The present study aimed to investigate the Sox10 expression in the pathological diagnosis of triple-negative breast cancer (TNBC). Furthermore, its correlation with the clinicopathological characteristics and disease-free survival rate in patients with TNBC was also evaluated to identify the diagnostic utility of Sox10 as a reliable biomarker for diagnosis and prognosis of TNBC. Methods Using immunohistochemistry, we identified the expression of Sox10, GATA-3, FOXA1, GCDFP15 and MGB in 376 cases of primary invasive breast cancer, and 77 cases of metastatic breast cancer. The expression of Sox10 in different molecular subtypes of primary invasive breast cancer and metastatic breast cancer were also compared. Furthermore, the correlation between Sox10 expression and clinicopathological parameters and disease-free survival (DFS) of patients with primary TNBC were also analyzed. Results Expression of Sox10 was only detected in the myoepithelial cells of normal breast, but not in any other types of cells, including luminal cell and fibroblasts. The positive rate of Sox10 in primary and metastatic TNBC was significantly higher than that in the other two types (P < 0.001, P < 0.001, respectively). The sensitivity and specificity of Sox10 expression in primary TNBC and metastatic TNBC were significantly lower than GATA-3, significantly higher than FOXA1, GCDFP15, and MGB (P < 0.001, P = 0.0004, P = 0.0064, P = 0.0229, respectively). In 71 cases of primary TNBC, a higher expression rate of Sox10 was significantly associated with high-grade tumors, late-stage tumors, and tumors with involvement of four or more lymph node metastases (P = 0.0145, P = 0.0105, P = 0.0249, respectively). Conclusion Sox10 may be used as a novel reliable putative marker for the diagnosis of TNBC. Notably, Sox10 combined with GATA-3 expression may serve as a supplementary differential diagnostic biomarker for primary and metastatic TNBC. Besides, Sox10 may be a good predictor of the prognosis of primary and metastatic TNBC. This study also highlights the significance of targeting Sox10 as a promising potential therapeutic target gene for TNBC therapy.