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Risk of skin cancer following tamoxifen treatment in more than 16,000 breast cancer patients: a cohort study

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Abstract

Background

Women with breast cancer are at increased risk of developing skin cancer. Little is known about how tamoxifen affects this risk. We aimed to investigate whether tamoxifen treatment following breast cancer is associated with skin cancer.

Methods

A cohort consisting of 44,589 women diagnosed with breast cancer during 1977–2007 from the nationwide clinical database of the Danish Breast Cancer Cooperative Group, was followed for a primary skin cancer [basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or melanoma] in the Danish Cancer Registry supplemented by data on BCC and SCC from the Danish Pathology Register. We investigated incidence of skin cancer among 16,214 women treated with tamoxifen compared to 28,375 women not treated with tamoxifen by calculating incidence rate ratios (IRRs) in Cox regression models.

Results

Tamoxifen users were followed for a median of 2.9 years. The median duration of tamoxifen treatment increased from around 1 year among women diagnosed before 1999 to nearly 2.5 years among women diagnosed in 1999 or later. Women treated with tamoxifen had an IRR 1.06 (95 % CI 0.72–1.55) for SCC and an IRR 1.40 (95 % CI 0.95–2.08) for melanoma when compared to non-users. The observed number of these types of cancer (37 SCCs and 38 melanomas among users) did not allow stratification on calendar-period. The overall IRR for BCC was 0.96 (95 % CI 0.84–1.09), but the IRR differed by menopausal status and calendar-period at diagnosis of breast cancer.

Conclusions

Our overall results indicate that tamoxifen is not associated with skin cancer. However, the inconsistency of results from stratifications prevents a firm conclusion.

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Acknowledgments

This study was funded by The Danish Cancer Society (Grant No. DP08095).

Author information

Authors and Affiliations

  1. Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Camilla Praestegaard, Susanne K. Kjaer & Lene Mellemkjaer

  2. Gynecological Clinic, The Juliane Marie Center, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark

    Susanne K. Kjaer

  3. The Department of Oncology, The Finsen Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Michael Andersson

  4. Danish Breast Cancer Cooperative Group, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Michael Andersson

  5. Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark

    Marianne Steding-Jensen

  6. Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark

    Kirsten Frederiksen

Authors
  1. Camilla Praestegaard
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  2. Susanne K. Kjaer
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  3. Michael Andersson
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  4. Marianne Steding-Jensen
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  6. Lene Mellemkjaer
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Corresponding author

Correspondence to Lene Mellemkjaer.

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Conflict of interest

The authors declare that they have no conflicts interests.

Ethical standard

The study was approved by the Danish Data Protection Agency. Approvals from Ethical Committees and written consent from study participants were not obtained, since in Denmark these are not required for register-based studies that do not involve contact with study participants and collection of biological samples.

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Praestegaard, C., Kjaer, S.K., Andersson, M. et al. Risk of skin cancer following tamoxifen treatment in more than 16,000 breast cancer patients: a cohort study. Breast Cancer 23, 908–916 (2016). https://doi.org/10.1007/s12282-015-0660-5

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  • DOI: https://doi.org/10.1007/s12282-015-0660-5

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