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Breast cancer in postmenopausal women after non-melanomatous skin cancer: the Women’s Health Initiative observational study

  • Epidemiology
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Abstract

An increased risk of breast cancer has been reported in patients with non-melanomatous skin cancer (NMSC), but this association has not been studied in a large, multi-geographic population. We utilized data from the Women’s Health Initiative observational study to assess whether history of NMSC is associated with breast cancer risk. This analysis included 70,246 postmenopausal White and Hispanic women aged 50–79, in which 4,247 breast cancer cases were identified over a mean (SD) of 11.3 (3.2) years. Baseline information was collected on demographics, medical history, sun exposure, and vitamin D intake. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95 % confidence intervals (CIs). The relationship between NMSC and breast cancer was examined as a time-dependent exposure using updated information on NMSC gathered during follow-up visits. All statistical tests were two sided. There were 5,595 women diagnosed with NMSC at study entry. The annualized rate of breast cancer was 0.64 % among women with a history of NMSC and 0.55 % among women with no history of NMSC. The multivariable-adjusted HR for breast cancer among women with a history of NMSC versus no history of NMSC was 1.07 (95 % CI 0.95–1.20, P = 0.27). Further evaluation stratified by tumor characteristics showed an increased risk of lymph node-positive disease, HR = 1.30 (95 % CI 1.01–1.67, P = 0.04), and regional-stage disease, HR = 1.33 (95 % CI 1.05–1.70, P = 0.02), among women with NMSC. There was no significant overall association between NMSC and breast cancer; however, there was an increased risk of more advanced-stage breast cancer which needs further exploration.

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Acknowledgments

We acknowledge the dedicated efforts of investigators and staff at the Women’s Health Initiative (WHI) clinical centers, the WHI Clinical Coordinating Center, and the National Heart, Lung, and Blood program office (listing available at http://www.whi.org). We also recognize the WHI participants for their extraordinary commitment to the WHI program. For a list of all the investigators who have contributed to the WHI science, please visit http://www.whiscience.org/publications/WHI_investigators_longlist.pdf. The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221, and the Cancer Center Support Grant NIH: NCI P30CA022453.

Conflict of interest

There are no conflicts of interest or financial relationships with the organization that sponsored the research.

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There are no financial disclosures from the authors.

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Authors and Affiliations

  1. Wayne State University School of Medicine, Detroit , MI, USA

    Mary Pressler

  2. NorthShore University Health System, Evanston, IL, USA

    Carol A. Rosenberg & Janardan Khandekar

  3. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Benjamin A. Derman & Philip Greenland

  4. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Rebecca J. Rodabough & Anne McTiernan

  5. Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University, 4100 John R, 4221 HWCRC, Detroit, MI, USA

    Michael S. Simon

  6. Population Studies and Prevention Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA

    Michael S. Simon

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  1. Mary Pressler
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Correspondence to Michael S. Simon.

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Pressler, M., Rosenberg, C.A., Derman, B.A. et al. Breast cancer in postmenopausal women after non-melanomatous skin cancer: the Women’s Health Initiative observational study. Breast Cancer Res Treat 139, 821–831 (2013). https://doi.org/10.1007/s10549-013-2578-y

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  • DOI: https://doi.org/10.1007/s10549-013-2578-y

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