Survival in Danish patients with breast cancer and inflammatory bowel disease: A nationwide cohort study
Survival in Danish patients with breast cancer and inflammatory bowel disease: A nationwide cohort study
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DOI：
10.1002/ibd.20341
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发表时间：
2008-04-01
影响因子：
4.9
通讯作者：
Lash, Timothy L.
中科院分区：
文献类型：
--
作者：
Sogaard, Kirstine Kobberoe;Cronin-Fenton, Deirdre P.;Lash, Timothy L.
背景：过去几十年来，炎症性肠病（IBD）和乳腺癌的发病率有所增加。然而，IBD 对乳腺癌预后的影响尚不清楚。因此，我们研究了 IBD 对乳腺癌患者接受治疗和生存的影响。方法：1980 年至 2004 年间诊断的乳腺癌患者（分期和治疗）的信息来自丹麦癌症登记处。 IBD 和潜在混杂因素的数据取自覆盖所有丹麦医院的丹麦国家患者登记处。 Cox 回归用于计算 IBD 乳腺癌患者与非 IBD 患者相比的死亡率比 (MRR)，并根据年龄、分期、查尔森指数测量的合并症和日历年进行调整。结果：我们确定了 71,148 例乳腺癌病例； 67 人还患有克罗恩病 (CD)，216 人患有溃疡性结肠炎 (UC)。与无 IBD 的患者相比，CD 患者的分期更晚，且接受的放疗较少，化疗较多。在调整后的分析中，患有和不患有IBD的乳腺癌患者的生存率没有显着差异（MRRCD = 1.22；95%置信区间[CI] = 0.85-1.75；MRRUC = 1.09；95% CI = 0.86-1.38）。在分层分析中，化疗与 CD 患者较差的生存率相关（MRRCD = 1.93；95% CI = 1.00-3.72）。结论：患有 UC 的乳腺癌患者接受相同的治疗，并且与不患有 IBD 的乳腺癌患者具有相似的生存率。相比之下，患有 CD 的乳腺癌患者接受放射治疗的频率较低。与没有 IBD 的患者相比，接受化疗的 CD 患者的乳腺癌生存率较差。
Background: incidences of inflammatory bowel disease (IBD) and of breast cancer have increased over the last decades. The influence of IBD on breast cancer prognosis, however, is unknown. We therefore examined the impact of IBD on treatment receipt and survival in breast cancer patients.Methods: Information on breast cancer patients (stage and treatment) diagnosed between 1980 and 2004 was sourced from the Danish Cancer Registry. Data on IBDand potential confounders were extracted from the Danish National Registry of Patients covering all Danish hospitals. Cox regression was used to compute mortality rate ratios (MRRs) among breast cancer patients with IBD, compared to their non-IBD counterparts, adjusting for age, stage, comorbidity measured by the Charlson Index, and calendar year.Results: We identified 71,148 breast cancer cases; 67 also had Crohn's disease (CD) and 216 had ulcerative colitis (UC). Patients with CD had more advanced stage and received radiotherapy less, and chemotherapy more, frequently than patients without IBD. In the adjusted analyses there was no substantial survival difference in breast cancer patients with and without IBD (MRRCD = 1.22; 95% confidence interval [CI] = 0.85-1.75; MRRUC = 1.09; 95% CI = 0.86-1.38). In a stratified analysis, chemotherapy was associated with poorer survival in patients with CD (MRRCD = 1.93; 95% CI = 1.00-3.72).Conclusions: Breast cancer patients with UC receive the same treatment and have similar survival to breast cancer without IBD. In contrast, breast cancer patients with CD are treated with radiotherapy less often. Survival of breast cancer in patients with CD treated with chemotherapy is poorer compared to survival in patients without IBD.