Prognosis, stage and oestrogen receptor status of contralateral breast cancer in relation to characteristics of the first tumour, prior endocrine treatment and radiotherapy
| Autor: | Anna Ehinger, Pär-Ola Bendahl, Mårten Fernö, Sara Alkner, Lisa Rydén |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Time Factors Antineoplastic Agents Hormonal medicine.medical_treatment Population Breast Neoplasms Metastasis Predictive Value of Tests Risk Factors Internal medicine parasitic diseases Biomarkers Tumor Humans Medicine Endocrine system Registries Neoplasm Metastasis Stage (cooking) education Neoplasm Staging Proportional Hazards Models education.field_of_study Radiotherapy business.industry Proportional hazards model Neoplasms Second Primary Middle Aged Prognosis medicine.disease Immunohistochemistry Radiation therapy Receptors Estrogen Tissue Array Analysis Cancer and Oncology Predictive value of tests Female Receptors Progesterone business Tamoxifen medicine.drug |
| Zdroj: | European Journal of Cancer; 51(16), pp 2304-2313 (2015) |
| ISSN: | 0959-8049 1879-0852 |
| Popis: | Aim A contralateral breast cancer (CBC) is today treated as an independent primary tumour, although recent data suggest risk and prognosis of CBC to be influenced by characteristics of and treatment given for the first tumour (BC1). We hereby investigate phenotypical and prognostic features of the second tumour (BC2) in relation to prior endocrine treatment and radiotherapy. Methods From a well-defined population-based cohort of CBC-patients, we have constructed a unique tissue-microarray including 600 pairs of primary tumours and CBCs. Breast cancer mortality was primary end-point for prognosis. Results Both oestrogen receptor (ER) status and stage was strongly correlated between BC1 and BC2 within CBC-pairs. Although BC2 had the highest prognostic impact, BC1 continued to influence prognosis after diagnosis of CBC. Patients diagnosed with two high stage tumours within a short time-interval had a particularly bad prognosis. Prior endocrine therapy and radiotherapy both correlated to ER-negativity of BC2. An ER-negative BC2 was associated with an inferior prognosis compared to an ER-positive BC2 regardless of ER-status of BC1 or prior endocrine therapy. Conclusions Our results suggest that both the residual prognostic impact of BC1, the possibility of contralateral metastasis, as well as prior treatment given, need to be considered when determining appropriate diagnostic work-up and treatment of CBC. In addition, radiation to the contralateral breast and risk of inducing CBC with an aggressive ER-negative phenotype should be considered when establishing new radiation treatment techniques. This study indicates loss of ER-expression as an important ‘endocrine treatment escape mechanism’, although further studies are warranted. |
| Databáze: | OpenAIRE |
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