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Survival in elderly patients with breast cancer with and without autoimmune disease.

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Název: Survival in elderly patients with breast cancer with and without autoimmune disease.
Autoři: Dedousis D; Department of Internal Medicine, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Zhang AL; Department of Internal Medicine, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Vassiliou AN; Case Western Reserve University, Cleveland, Ohio, USA., Cao S; Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA., Yammani D; Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Kyasaram RK; Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Shanahan JP; Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Keinath MC; Department of Pathology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Hsu ML; Division of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Fu P; Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA., Dowlati A; Division of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA., Montero AJ; Division of Hematology and Oncology, Case Western Reserve University and University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Zdroj: Cancer medicine [Cancer Med] 2023 Jun; Vol. 12 (12), pp. 13086-13099. Date of Electronic Publication: 2023 Apr 26.
Způsob vydávání: Journal Article; Research Support, Non-U.S. Gov't
Jazyk: English
Informace o časopise: Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE
Imprint Name(s): Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-
Výrazy ze slovníku MeSH: Breast Neoplasms*/epidemiology , Breast Neoplasms*/therapy , Breast Neoplasms*/diagnosis , Autoimmune Diseases*/complications , Autoimmune Diseases*/epidemiology, Humans ; Female ; Aged ; United States/epidemiology ; Medicare ; SEER Program ; Neoplasm Staging
Abstrakt: Background: Patients with certain autoimmune conditions are at a reduced risk of developing breast cancer compared to the general population. Despite this, little is known about outcomes in patients with breast cancer who have a concurrent autoimmune diagnosis.
Methods: This study compared differences in outcomes between women with breast cancer who had or did not have an autoimmune diagnosis. The SEER-Medicare databases (2007-2014) were used to identify patients with breast cancer and diagnosis codes were used to identify those with an autoimmune disorder.
Results: The studied autoimmune diseases had a prevalence of 27% among the 137,324 patients with breast cancer. Autoimmune disease was associated with significantly longer overall survival (OS) and significantly lower cancer-specific mortality (CSM) among stage IV breast cancer patients (p < 0.0001). After controlling for the effects of age, race, chronic kideny disease, chemotherapy, and radiation therapy autoimmune disease was still predictive of improved OS (HR: 1.45, 95% CI: 1.35-1.55, p < 0.0001) and CSM (HR: 1.40, 95% CI: 1.29-1.5, p < 0.0001). By contrast, in patients with stage I-III breast cancer, the presence of an autoimmune diagnosis was associated with a lower OS (p < 0.0001, p < 0.0001, and p = 0.026, respectively), compared to patients without autoimmune disease.
Conclusions: We found a higher prevalence of rheumatoid arthritis, Crohn's disease, ulcerative colitis, and systemic lupus erythematosus in patients with breast cancer compared to age matched cohorts in the general population. The presence of an autoimmune diagnosis was associated with a lower OS in stages I-III breast cancer and improved OS and CSM in patients with stage IV disease. These results suggest that anti-tumor immunity plays an important role in late stage breast cancer and could potentially be exploited to improve the effectiveness of immunotherapy.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
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Contributed Indexing: Keywords: Medicare; statistics & numerical data; SEER program; statistics & numerical data; autoimmune diseases; breast neoplasms; prevalence; survival analysis
Entry Date(s): Date Created: 20230427 Date Completed: 20230704 Latest Revision: 20230705
Update Code: 20250114
PubMed Central ID: PMC10315719
DOI: 10.1002/cam4.5989
PMID: 37102221
Databáze: MEDLINE
Popis
Abstrakt:Background: Patients with certain autoimmune conditions are at a reduced risk of developing breast cancer compared to the general population. Despite this, little is known about outcomes in patients with breast cancer who have a concurrent autoimmune diagnosis.<br />Methods: This study compared differences in outcomes between women with breast cancer who had or did not have an autoimmune diagnosis. The SEER-Medicare databases (2007-2014) were used to identify patients with breast cancer and diagnosis codes were used to identify those with an autoimmune disorder.<br />Results: The studied autoimmune diseases had a prevalence of 27% among the 137,324 patients with breast cancer. Autoimmune disease was associated with significantly longer overall survival (OS) and significantly lower cancer-specific mortality (CSM) among stage IV breast cancer patients (p &lt; 0.0001). After controlling for the effects of age, race, chronic kideny disease, chemotherapy, and radiation therapy autoimmune disease was still predictive of improved OS (HR: 1.45, 95% CI: 1.35-1.55, p &lt; 0.0001) and CSM (HR: 1.40, 95% CI: 1.29-1.5, p &lt; 0.0001). By contrast, in patients with stage I-III breast cancer, the presence of an autoimmune diagnosis was associated with a lower OS (p &lt; 0.0001, p &lt; 0.0001, and p = 0.026, respectively), compared to patients without autoimmune disease.<br />Conclusions: We found a higher prevalence of rheumatoid arthritis, Crohn's disease, ulcerative colitis, and systemic lupus erythematosus in patients with breast cancer compared to age matched cohorts in the general population. The presence of an autoimmune diagnosis was associated with a lower OS in stages I-III breast cancer and improved OS and CSM in patients with stage IV disease. These results suggest that anti-tumor immunity plays an important role in late stage breast cancer and could potentially be exploited to improve the effectiveness of immunotherapy.<br /> (© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
ISSN:2045-7634
DOI:10.1002/cam4.5989