Estrogen receptor status of primary breast cancer is predictive of estrogen receptor status of contralateral breast cancer
Estrogen receptor status of primary breast cancer is predictive of estrogen receptor status of contralateral breast cancer
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DOI：
10.1093/jnci/djh097
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发表时间：
2004-04-07
期刊：
影响因子：
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通讯作者：
Wolmark, N
中科院分区：
文献类型：
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作者：
Swain, SM;Wilson, JW;Wolmark, N
背景资料：他莫昔芬降低对侧乳腺癌的风险约30%-50%，其益处可能仅限于雌激素受体（ER）阳性原发病的女性。在对国家外科和辅助乳腺和肠道项目试验B-18、B-22和B-25数据的回顾性分析中，我们确定原发性乳腺癌的ER状态是否可预测随后对侧乳腺癌的ER状态，以及他莫昔芬治疗是否影响这种关系。在这些试验中，他莫昔芬20 mg/天仅用于50岁或以上的女性，而不是那些由原发性肿瘤的ER状态确定的女性，从而可以评估治疗对ER阴性疾病的影响。方法：在5513例符合条件的患者中，176例患者发生了对侧乳腺癌。确定原发肿瘤和对侧肿瘤的ER状态，并对未接受他莫昔芬的女性进行交叉分类（即，年龄在49岁或以下的人）和这样做的妇女（即，50岁或以上）。ER数据可用于110例可评价的浸润性对侧乳腺癌。结果如下：在未接受他莫昔芬治疗的患者中（n = 62），89%的ER阳性原发性乳腺癌患者的对侧乳腺癌为ER阳性，70%的ER阴性原发性乳腺癌患者的对侧乳腺癌为ER阴性（原发和对侧ER状态之间相关性的比值比= 14.8，95%置信区间= 3.8至74.3; P <0.001）。在接受他莫昔芬治疗的患者中（n = 48），56%的ER阳性原发癌患者发生ER阳性对侧乳腺癌，78%的ER阴性原发癌患者发生ER阴性对侧乳腺癌（比值比= 3.4，95%置信区间= 0.53至39.2; P = 0.25）。结论：对于未接受他莫昔芬治疗的患者，原发性乳腺癌的ER状态与对侧乳腺的ER状态相关。接受他莫昔芬治疗的ER阳性原发癌患者与ER阳性对侧乳腺癌患者的一致率较低，这可能是他莫昔芬治疗的结果。
Background: Tamoxifen reduces the risk for contralateral breast cancer by approximately 30%-50%, with benefits probably limited to women with estrogen receptor (ER)-positive primary disease. In a retrospective analysis of data from National Surgical and Adjuvant Breast and Bowel Project trials B-18, B-22, and B-25, we determined whether the ER status of primary breast cancer predicts the ER status of a subsequent contralateral breast cancer and whether tamoxifen treatment affects this relationship. In these trials, tamoxifen at 20 mg/day had been administered only to women aged 50 years or older, rather than to those determined by the ER status of their primary tumor, allowing an assessment of the treatment's effects in ER-negative disease. Methods: Among the 5513 eligible patients, 176 patients developed a contralateral breast cancer. The ER status of the primary and contralateral tumor was determined and cross-classified for women who did not receive tamoxifen (i.e., those aged 49 years or younger) and for women who did (i.e., those aged 50 years or older). ER data were available for 110 evaluable invasive contralateral breast cancers. Results: Among patients who did not receive tamoxifen (n = 62), 89% with an ER-positive primary cancer had an ER-positive contralateral breast cancer and 70% with an ER-negative primary breast cancer had an ER-negative contralateral breast cancer (odds ratio for the association between primary and contralateral ER status = 14.8, 95% confidence interval = 3.8 to 74.3; P < .001). Among patients who received tamoxifen (n = 48), 56% with an ER-positive primary cancer had an ER-positive contralateral breast cancer and 78% with an ER-negative primary cancer had an ER-negative contralateral breast cancer (odds ratio = 3.4, 95% confidence interval = 0.53 to 39.2; P = .25). Conclusion: The ER status of the primary breast cancer was associated with that of the contralateral breast for patients not receiving tamoxifen. Patients with an ER-positive primary cancer who received tamoxifen had a lower concordance rate with fewer ER-positive contralateral breast cancers, which may be a result of tamoxifen treatment.