© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 13, 1008-1013,
July 4, 2001
© 2001 Oxford University Press
|
|
REPORT |
Tamoxifen Therapy for Primary Breast Cancer and Risk of Contralateral Breast Cancer
Affiliation of authors: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Correspondence to: Christopher I. Li, M.D., M.P.H., Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave., North, MP 381, P.O. Box 19024, Seattle, WA 98109–1024 (e-mail: cili{at}fhcrc.org).
Background: Women diagnosed with breast cancer have a twofold to sixfold greater risk of developing contralateral breast cancer than women in the general population have of developing a first breast cancer. Tamoxifen therapy reduces this risk, but it is unclear if this benefit exists for both estrogen receptor (ER)-positive and ER-negative contralateral tumors. Methods: Using data from a population-based tumor registry that collects information on the ER status of breast tumors, we followed 8981 women residing in western Washington State who were diagnosed with a primary unilateral invasive breast cancer during the period from 1990 through 1998 to identify cases of contralateral breast cancer. We restricted our analyses to women who were at least 50 years old and whose first breast cancer had a localized or regional stage; women who received adjuvant hormonal therapy but not chemotherapy (n = 4654) were classified as tamoxifen users, while those who received neither adjuvant hormonal therapy nor chemotherapy (n = 4327) were classified as nonusers of tamoxifen. By reviewing selected patient abstracts, we estimated that 94% of the subjects were classified correctly with respect to tamoxifen use. The risk of contralateral breast cancer associated with tamoxifen use was estimated with the use of Cox regression. All statistical tests were two-sided. Results: Of the 89 tamoxifen users and 100 nonusers of tamoxifen diagnosed with contralateral breast cancer, 112 had ER-positive tumors, 20 had ER-negative tumors, and 57 had tumors with an ER status that was unknown or had not been determined by an immunohistochemical assay. The risk of developing an ER-positive and an ER-negative contralateral tumor among tamoxifen users was 0.8 (95% confidence interval [CI] = 0.5 to 1.1) and 4.9 (95% CI = 1.4 to 17.4), respectively, times that of nonusers of tamoxifen. This difference in risk by ER status was statistically significant (P<.0001). Conclusions: Tamoxifen use appears to decrease the risk of ER-positive contralateral breast tumors, but it appears to increase the risk of ER-negative contralateral tumors.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Bertelsen, L. Bernstein, J. H. Olsen, L. Mellemkjaer, R. W. Haile, C. F. Lynch, K. E. Malone, H. Anton-Culver, J. Christensen, B. Langholz, et al. Effect of Systemic Adjuvant Treatment on Risk for Contralateral Breast Cancer in the Women's Environment, Cancer and Radiation Epidemiology Study J Natl Cancer Inst, January 2, 2008; 100(1): 32 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hemminki, J. Ji, and A. Forsti Risks for Familial and Contralateral Breast Cancer Interact Multiplicatively and Cause a High Risk Cancer Res., February 1, 2007; 67(3): 868 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Arpino, H.L. Weiss, G.M. Clark, S.G. Hilsenbeck, and C.K. Osborne Hormone Receptor Status of a Contralateral Breast Cancer Is Independent of the Receptor Status of the First Primary in Patients Not Receiving Adjuvant Tamoxifen J. Clin. Oncol., July 20, 2005; 23(21): 4687 - 4694. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ziv, J. Tice, R. Smith-Bindman, J. Shepherd, S. Cummings, and K. Kerlikowske Mammographic Density and Estrogen Receptor Status of Breast Cancer Cancer Epidemiol. Biomarkers Prev., December 1, 2004; 13(12): 2090 - 2095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. P. Jacobs, B. Burns, R. Marya, J. Chapman, B. Stone, S. Hwang, M. Goldman, K. Barrows, D. Hamolsky, and K. Sampel Integrative Tumor Board: Recurrent Breast Cancer or New Primary? Integr Cancer Ther, September 1, 2003; 2(3): 289 - 300. [PDF]
|
|
|
|
 |
|
 G. Pichert, B. Bolliger, K. Buser, and O. Pagani Evidence-based management options for women at increased breast/ovarian cancer risk Ann. Onc., January 1, 2003; 14(1): 9 - 19. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Bachleitner-Hofmann, B. Pichler-Gebhard, M. Rudas, M. Gnant, S. Taucher, D. Kandioler, E. Janschek, P. Dubsky, S. Roka, E. Sporn, et al. Pattern of Hormone Receptor Status of Secondary Contralateral Breast Cancers in Patients Receiving Adjuvant Tamoxifen Clin. Cancer Res., November 1, 2002; 8(11): 3427 - 3432. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski, N. Col, E. P. Winer, D. E. Collyar, S. R. Cummings, V. G. Vogel III, H. J. Burstein, A. Eisen, I. Lipkus, and D. G. Pfister American Society of Clinical Oncology Technology Assessment of Pharmacologic Interventions for Breast Cancer Risk Reduction Including Tamoxifen, Raloxifene, and Aromatase Inhibition J. Clin. Oncol., August 1, 2002; 20(15): 3328 - 3343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. G. Vogel Why Do We Still Use Hormone Replacement Therapy? Why Don't We Use It More? J. Clin. Oncol., February 1, 2002; 20(3): 616 - 619. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Lippman and W. Ki Hong Cancer Prevention by Delay : Commentary re: J. A. O'Shaughnessy et al., Treatment and Prevention of Intraepithelial Neoplasia: An Important Target for Accelerated New Agent Development. Clin. Cancer Res., 8: 314-346, 2002. Clin. Cancer Res., February 1, 2002; 8(2): 305 - 313. [Full Text] [PDF]
|
|
|
|
|
|
C. I. Li, K. E. Malone, N. S. Weiss, and J. R. Daling Re: Tamoxifen and Contralateral Breast Cancer: the Other Side J Natl Cancer Inst, November 21, 2001; 93(22): 1753 - 1753. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Swain RESPONSE: Re: Tamoxifen and Contralateral Breast Cancer: the Other Side J Natl Cancer Inst, November 21, 2001; 93(22): 1753 - 1754. [Full Text] [PDF]
|
|
|
|
|
|
C. W. Lee, L. Weir, and K. A. Gelmon Effect of News Media Coverage of Cancer Risk on Clinical Oncology Practice J Natl Cancer Inst, November 7, 2001; 93(21): 1656 - 1657. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Swain Tamoxifen and Contralateral Breast Cancer: the Other Side J Natl Cancer Inst, July 4, 2001; 93(13): 963 - 965. [Full Text] [PDF]
|
|