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Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers |
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| Authors: | Jacek Gronwald Andre Robidoux Charmaine Kim-Sing Nadine Tung Henry T. Lynch William D. Foulkes Siranoush Manoukian Peter Ainsworth Susan L. Neuhausen Rochelle Demsky Andrea Eisen Christian F. Singer Howard Saal Leigha Senter Charis Eng Jeffrey Weitzel Pal Moller Dawna M. Gilchrist Olufunmilayo Olopade Ophira Ginsburg Ping Sun Tomasz Huzarski Jan Lubinski Steven A. Narod |
| Affiliation: | 1. Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland 2. Epidemiology Research Unit, Research Center of the University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada 3. BC Cancer Agency, Vancouver, BC, Canada 4. Beth Israel Deaconess Hospital, Boston, MA, USA 5. Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA 6. Programs in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montreal, QC, Canada 7. Istituto Nazionale de Tumori, Milan, Italy 8. London Regional Cancer Program, London, ON, Canada 9. Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA 10. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada 11. Sunnybrook Regional Cancer Center, Toronto, ON, Canada 12. Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria 13. Division of Medical Genetics, Children’s Hospital Medical Center, Cincinnati, OH, USA 14. Division of Human Genetics, Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA 15. Genomic Medicine Institute, Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, USA 16. Division of Clinical Cancer Genetics, City of Hope Medical Center, Duarte, CA, USA 17. Norwegian Radium Institute, Oslo, Norway 18. Department of Medicine Genetics, University of Alberta, Edmonton, AB, Canada 19. University of Chicago, Chicago, IL, USA 20. Department of Medicine, University of Toronto, Toronto, ON, Canada 21. Women’s College Research Institute, Toronto, ON, Canada |
| Abstract: | Women with a mutation in BRCA1 or BRCA2 face a lifetime risk of breast cancer of approximately 80 %. Tamoxifen treatment of the first cancer has been associated with a reduction in the risk of a subsequent contralateral cancer. We studied 1,504 women with a known BRCA1 or BRCA2 mutation, 411 women with bilateral breast cancer (cases) and 1,093 women with unilateral breast cancer (controls) in a matched case–control study. Control women were of similar age and had a similar age of diagnosis of first breast cancer as the cases. For each woman who used tamoxifen, the starting and stopping dates were abstracted and the duration of tamoxifen use was calculated. Three hundred and thirty-one women had used tamoxifen (22 %); of these 84 (25 %) had completed four or more years of tamoxifen, the remainder stopped prematurely or were current users. For women with up to 1 year of tamoxifen use, the odds ratio for contralateral breast cancer was 0.37 (95 % CI 0.20–0.69; p = 0.001) compared to women with no tamoxifen use. Among women with 1–4 years of tamoxifen use the odds ratio was 0.53 (95 % CI 0.32–0.87; p = 0.01). Among women with four or more years of tamoxifen use the odds ratio was 0.83 (95 % CI 0.44–1.55; p = 0.55). Short-term use of tamoxifen for chemoprevention in BRCA1 and BRCA2 mutation carriers may be as effective as a conventional 5-year course of treatment. |
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