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The influence of treatment on hormone receptor subgroups and breast cancer-specific mortality within US integrated healthcare systems

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A Correction to this article was published on 10 October 2022

This article has been updated

Abstract

Purpose

Estrogen receptor (ER) + /progesterone receptor (PR) – or ER−/PR + breast cancer prognosis has not been well-described outside of clinical trials. We evaluated the relationship between ER/PR (ER + /PR−, ER−/PR + , ER + /PR + , ER−/PR−) subgroups and breast cancer-specific mortality within a general community setting in the US.

Methods

A Retrospective cohort of 11,737 women diagnosed with breast cancer between 1990 and 2016 within US integrated healthcare systems (median follow-up = 7 years; 1,104 breast cancer-specific deaths) were included in this analysis. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for site, demographic and clinicopathological characteristics, and treatment (surgery/radiotherapy, chemotherapy, endocrine therapy).

Results

Breast cancer-specific mortality was higher for those with ER + /PR− (n = 1,233) compared with ER + /PR + tumors (n = 8,439) before (HR = 1.43; 95% CI = 1.17–1.75) and after treatment adjustment (HR = 1.58; 95% CI = 1.27–1.97). ER + /PR− breast cancer-specific mortality remained higher than ER + /PR + tumors when stratified by treatment received. Breast cancer-specific mortality was similar in ER–/PR + (n = 161) compared with ER + /PR + tumors.

Conclusion

Our findings suggest that ER + /PR− tumors may have worse breast cancer-specific mortality than ER + /PR + tumors in a community setting.

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Fig. 1

Data availability

The datasets generated or analyzed during the current study are not publicly available due to data privacy of patients. The authors will make the data available upon reasonable request.

Change history

Abbreviations

ER:

Estrogen receptor

PR:

Progesterone receptor

KP:

Kaiser permanente

SEER:

Surveillance, epidemiology, and end results

HR:

Hazard ratio

CI:

Confidence interval

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Funding

This work was supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics of the US National Cancer Institute. Data collected at Kaiser Permanente Colorado was supported by contracts from the National Cancer Institute (HHSN 261201800469P, HHSN 261201700708P, HHSN 261201600711P) and a subcontract with RTI International (HHSN 26120090017C). Data collected at Kaiser Permanente Washington was supported by grants from NIH (1R01CA1205621 and P01CA154292) and contracts from NCI (HHSN 261201700564P, HHSN75N91019P00076, HHSN 5N91020P00327). Cancer incidence data used in this study was supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, which is funded by Contract No. N01-CN-67009 and N01-PC-35142 from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center and the State of Washington. Erin Bowles’s time was also supported by the National Cancer Institute (R50CA211115).

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Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, 9609 Medical Center Drive, Bethesda, MD, USA

    Cody Ramin, Gretchen L. Gierach, Mustapha Abubakar, Lene H. S. Veiga, Jacqueline B. Vo, Rochelle E. Curtis, Amy Berrington de Gonzalez & Clara Bodelon

  2. Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA

    Erin J. Aiello Bowles & Diana S. M. Buist

  3. Bernard J. Tyson Kaiser Permanente School of Medicine, Pasadena, CA, USA

    Heather Spencer Feigelson & Diana S. M. Buist

  4. Institute for Health Research, Kaiser Permanente, Denver, CO, USA

    Heather Spencer Feigelson

Authors
  1. Cody Ramin
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  2. Gretchen L. Gierach
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  3. Mustapha Abubakar
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  4. Lene H. S. Veiga
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  5. Jacqueline B. Vo
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  6. Rochelle E. Curtis
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  7. Erin J. Aiello Bowles
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  8. Heather Spencer Feigelson
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  9. Diana S. M. Buist
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  10. Amy Berrington de Gonzalez
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  11. Clara Bodelon
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Correspondence to Clara Bodelon.

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The original online version of this article was revised: the author’s name and the supplementary material has been updated.

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Ramin, C., Gierach, G.L., Abubakar, M. et al. The influence of treatment on hormone receptor subgroups and breast cancer-specific mortality within US integrated healthcare systems. Cancer Causes Control 33, 1019–1023 (2022). https://doi.org/10.1007/s10552-022-01589-4

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  • DOI: https://doi.org/10.1007/s10552-022-01589-4

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