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Estrogen-receptor status and risk of contralateral breast cancer following DCIS

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Abstract

Purpose

As local therapies improve, contralateral breast cancer (CBC) risk for women with ductal carcinoma in situ (DCIS) may exceed the risk of a second ipsilateral breast cancer. We sought to determine whether estrogen-receptor (ER) status influenced CBC risk.

Methods

We identified women aged 40–79 with DCIS diagnosed between 1990 and 2002 using the Surveillance, Epidemiology, and End Results database. We used multivariable competing risk regression to examine predictors of time from index DCIS to CBC (invasive or in situ).

Results

Multivariable competing risk regression found ER status to be a highly significant predictor of CBC. The 10-year cumulative incidence was estimated to be 5.3% (95% CI 4.8–5.8%) among ER positive (ER+) cases and 3.3% (95% CI 2.6–4.0%) among ER negative (ER−).

Conclusions

This finding suggests that ER+ DCIS may represent a field effect that confers increased propensity for developing cancer across breast tissue, regardless of laterality. In contrast, ER− DCIS may represent an isolated local event. Given that the majority of DCIS is ER+, and only a minority of DCIS patients receive hormonal therapy, consideration of ER status may influence treatment and surveillance approaches.

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Funding

This work was supported by the Patient-Centered Outcomes Research Institute (PCORI CE-12-11-4173). The views expressed in this article are those of the authors, and no official endorsement by PCORI is intended or should be inferred.

Author information

Authors and Affiliations

  1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

    Natasha K. Stout

  2. Division of Population Sciences, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA, USA

    Angel M. Cronin, Hajime Uno & Michael J. Hassett

  3. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA

    Elissa M. Ozanne

  4. Dana-Farber/Harvard Cancer Center Breast Cancer Advocacy Group, Dana-Farber Cancer Institute, Boston, MA, USA

    Elizabeth S. Frank

  5. Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine, Madison, WI, USA

    Caprice C. Greenberg

  6. Department of Radiation Therapy, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA, USA

    Rinaa S. Punglia

Authors
  1. Natasha K. Stout
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  2. Angel M. Cronin
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  3. Hajime Uno
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  4. Elissa M. Ozanne
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  5. Michael J. Hassett
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  6. Elizabeth S. Frank
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  7. Caprice C. Greenberg
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  8. Rinaa S. Punglia
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Corresponding author

Correspondence to Rinaa S. Punglia.

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Conflict of interest

None of the authors have any conflict of interest related to the subject matter presented.

Ethical approval

This article is a retrospective review of patient data, and was reviewed by the Dana–Farber/Harvard Cancer Center IRB and determined to be exempt. This article does not contain any studies with animals or human participants performed by any of the authors.

Additional information

IRB: This study was approved by the Institutional Review Boards at Dana–Farber/Harvard Cancer Center and Harvard Pilgrim Health Care Institute.

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Stout, N.K., Cronin, A.M., Uno, H. et al. Estrogen-receptor status and risk of contralateral breast cancer following DCIS. Breast Cancer Res Treat 171, 777–781 (2018). https://doi.org/10.1007/s10549-018-4860-5

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  • DOI: https://doi.org/10.1007/s10549-018-4860-5

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