Risk of second breast cancers after lobular carcinoma in situ according to hormone receptor status.
Risk of second breast cancers after lobular carcinoma in situ according to hormone receptor status.
复制标题
根据激素受体状态，小叶原位癌后第二次乳腺癌的风险
DOI：
10.1371/journal.pone.0176417
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Mao K;Yang Y;Wu W;Liang S;Deng H;Liu J
尽管原发性小叶原位癌（LCIS）后继发乳腺癌的风险已被深入研究，但首次LCIS后继发乳腺癌的风险是否随原发肿瘤的激素受体（HR）状态而变化仍不清楚。方法：我们从1998年至2007年的18个监测、流行病学和最终结果（SEER）登记中确定了10,304名原发性单纯单侧LCIS妇女。Kaplan-Meier估计的第二个同侧乳腺癌（IBC）和对侧乳腺癌（CBC）的5年或10年的概率进行了计算。采用多变量考克斯比例模型，以确定原发性LCIS的HR状态以及其他人口统计学、临床病理学或治疗特征对第二次IBC或CBC风险的影响。结果在本研究纳入的10,304例原发性LCIS患者中，9949例（96.5%）为HR+肿瘤，355例（3.5%）为HR-肿瘤。多变量校正分析显示，尽管HR+和HR- LCIS女性之间的总第二次IBC风险无差异（P = 0. 152），但HR+ LCIS患者的第二次浸润性IBC风险在统计学上低于HR- LCIS患者（风险比0. 356，95% CI 0. 141 - 0. 899，P = 0. 029）。原发性HR+ LCIS的女性与HR- LCIS的女性相比，第二次总CBCs和侵袭性CBCs的风险均较低（总CBCs：风险比0.340，95% CI 0.228-0.509，P<0.001;侵袭性CBCs：风险比0.172，95% CI 0.108-0.274，P<0.001）。此外，黑人女性发生随后总IBC的风险是白色女性的2倍（P = 0.028）。结论：这项基于人群的研究表明，与HR+ LCIS相比，HR-首次LCIS的女性发生第二次乳腺癌的风险显著增加。这些发现保证了对HR-LCIS幸存者的第二次乳腺癌的密切监测。
Background Although subsequent breast cancer risk after primary lobular carcinoma in situ (LCIS) has been studied intensively, whether the risk of second breast cancer after first LCIS varies with hormone receptor (HR) status of primary tumor remains unclear. Methods We identified 10,304 women with primary pure unilateral LCIS between 1998 and 2007 from the Surveillance, Epidemiology and End Results (SEER) 18 Registries. Kaplan–Meier estimates of 5 or 10-year probabilities of second ipsilateral breast cancers (IBCs) and contralateral breast cancers (CBCs) were calculated. Multivariable Cox proportional model was performed to identify impact of HR status of primary LCIS, and other demographic, clinicopathologic or treatment characteristics on risk of second IBCs or CBCs. Results Of the 10,304 women with primary LCIS included in this study, 9949 (96.5%) patients had HR+ tumors, and 355 (3.5%) had HR- tumors. Multivariable-adjusted analyses showed that although there was no difference in risk of total second IBCs between women with HR+ and HR- LCIS (P = 0.152), patients with HR+ LCIS had a statistically lower risk of second invasive IBCs compared to those with HR- LCIS (hazard ratio 0.356, 95% CI 0.141–0.899, P = 0.029). Women with primary HR+ LCIS had lower risks of both second total and invasive CBCs compared to those with HR- LCIS (total CBCs: hazard ratio 0.340, 95% CI 0.228–0.509, P<0.001; invasive CBCs: hazard ratio 0.172, 95% CI 0.108–0.274, P<0.001). Additionally, black women had a 2-fold risk of developing subsequent total IBCs than white women (P = 0.028). Conclusions This population-based study demonstrated that the risk of second breast cancers was significantly increased in women with HR- first LCIS compared to those with HR+ LCIS. These findings warrant intensive surveillance for second breast cancers in HR- LCIS survivors.