Prior breast cancer and tamoxifen exposure does not influence outcomes in women with uterine papillary serous carcinoma

Objectives

To evaluate progression-free survival (PFS) and overall survival (OS) outcomes in women diagnosed with uterine papillary serous carcinoma (UPSC) who have had (UPSCBR +) or have not had (UPSCBR ?) an antecedent history of breast cancer and to correlate their outcomes to prior tamoxifen exposure.

Methods

Data were collected for women diagnosed with UPSC at two academic institutions between January 1997 and July 2012. Patient demographics, tumor histology, stage, and treatments were recorded. Patients were divided into two groups: those with and without a personal history of breast cancer. Within the UPSCBR + cohort, we identified those with a history of tamoxifen use. Cox regression modeling was used to explore associations between selected covariates of interest and the time-to-event outcomes of PFS and OS.

Results

Of 323 patients with UPSC, 46 (14%) were UPSCBR +. Of these, 15 (33%) had a history of tamoxifen use. UPSCBR + patients were older than UPSCBR ? (median years, 72 vs. 68, p = 0.004). UPSCBR + women showed no significant difference in PFS or OS compared to UPSCBR ? (p = 0.64 and p = 0.73 respectively), even after controlling for age (p = 0.15 and p = 0.48 respectively). Within the UPSCBR + cohort, there was no difference in PFS or OS with or without tamoxifen exposure (p = 0.98 and p = 0.94 respectively).

Conclusions

There was no difference in PFS or OS between the UPSCBR + and UPSCBR ? cohorts. We did not demonstrate significant OS or PFS differences in women who took tamoxifen prior to their endometrial cancer diagnosis. These findings have implications for counseling, and should be encouraging to women who are facing their second cancer diagnosis.