Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status: a SEER analysis

Jieqiong Liu, Wen Jiang, Kai Mao, Yi An, Fengxi Su, Betty Y S Kim, Qiang Liu, Lisa Jacobs

Research output: Contribution to journalArticle

Abstract

Estrogen receptor (ER)-positive breast cancer patients treated with tamoxifen are known to have an elevated risk of subsequent endometrial cancer. However, it is unclear if ER-negative patients also have a higher risk of endometrial cancer. This population-based study aims to evaluate whether breast cancer patients with distinctive ER and PR status possess differential risks in developing delayed endometrial malignancy. Data were obtained from the Surveillance, Epidemiology, and End Results program (1992–2009). Standardized incidence ratio (SIR) was calculated as the observed cases of endometrial cancers among breast cancer survivors compared with the expected cases in the general population. Data were stratified by latency periods, race, age, and calendar year of breast cancer diagnosis. We identified 2044 patients who developed a second primary endometrial cancer among 289,933 breast cancer survivors. The overall SIRs for subsequent endometrial cancers were increased in all of the four subtypes (ER+PR+, ER+PR−, ER−PR+, and ER−PR−) of breast cancer. SIR was increased for all latency periods except for the initial 6–11 months after breast cancer diagnosis. Stratifying by age of diagnosis, elevated SIRs in all ER/PR groups were statistically significant among patients diagnosed with breast cancer after the age of 40. Demographically, non-Hispanic whites had increased SIRs in all subtypes of breast cancer, while Hispanic whites had no statistically elevated SIRs. Here we showed that patients with invasive breast cancer have a higher risk of developing subsequent endometrial cancer regardless of ER or PR status. The increased risk among hormone receptor-negative breast cancer survivors raises concerns whether common etiological factors among these breast cancer subtypes increase the susceptibility to develop endometrial cancer. Lower threshold for routine endometrial cancer surveillance may be warranted.

Original languageEnglish (US)
Pages (from-to)439-445
Number of pages7
JournalBreast Cancer Research and Treatment
Volume150
Issue number2
DOIs
StatePublished - 2015

Fingerprint

Endometrial Neoplasms
Survivors
Hormones
Breast Neoplasms
Estrogen Receptors
SEER Program
Second Primary Neoplasms
Incidence
Tamoxifen
Hispanic Americans
Population

Keywords

  • ER/PR status
  • First primary breast cancer
  • Increased risk
  • Subsequent endometrial cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status : a SEER analysis. / Liu, Jieqiong; Jiang, Wen; Mao, Kai; An, Yi; Su, Fengxi; Kim, Betty Y S; Liu, Qiang; Jacobs, Lisa.

In: Breast Cancer Research and Treatment, Vol. 150, No. 2, 2015, p. 439-445.

Research output: Contribution to journalArticle

Liu, Jieqiong ; Jiang, Wen ; Mao, Kai ; An, Yi ; Su, Fengxi ; Kim, Betty Y S ; Liu, Qiang ; Jacobs, Lisa. / Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status : a SEER analysis. In: Breast Cancer Research and Treatment. 2015 ; Vol. 150, No. 2. pp. 439-445.
@article{c24fb64b5bb14df2a1ea99e94f1aa8ca,
title = "Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status: a SEER analysis",
abstract = "Estrogen receptor (ER)-positive breast cancer patients treated with tamoxifen are known to have an elevated risk of subsequent endometrial cancer. However, it is unclear if ER-negative patients also have a higher risk of endometrial cancer. This population-based study aims to evaluate whether breast cancer patients with distinctive ER and PR status possess differential risks in developing delayed endometrial malignancy. Data were obtained from the Surveillance, Epidemiology, and End Results program (1992–2009). Standardized incidence ratio (SIR) was calculated as the observed cases of endometrial cancers among breast cancer survivors compared with the expected cases in the general population. Data were stratified by latency periods, race, age, and calendar year of breast cancer diagnosis. We identified 2044 patients who developed a second primary endometrial cancer among 289,933 breast cancer survivors. The overall SIRs for subsequent endometrial cancers were increased in all of the four subtypes (ER+PR+, ER+PR−, ER−PR+, and ER−PR−) of breast cancer. SIR was increased for all latency periods except for the initial 6–11 months after breast cancer diagnosis. Stratifying by age of diagnosis, elevated SIRs in all ER/PR groups were statistically significant among patients diagnosed with breast cancer after the age of 40. Demographically, non-Hispanic whites had increased SIRs in all subtypes of breast cancer, while Hispanic whites had no statistically elevated SIRs. Here we showed that patients with invasive breast cancer have a higher risk of developing subsequent endometrial cancer regardless of ER or PR status. The increased risk among hormone receptor-negative breast cancer survivors raises concerns whether common etiological factors among these breast cancer subtypes increase the susceptibility to develop endometrial cancer. Lower threshold for routine endometrial cancer surveillance may be warranted.",
keywords = "ER/PR status, First primary breast cancer, Increased risk, Subsequent endometrial cancer",
author = "Jieqiong Liu and Wen Jiang and Kai Mao and Yi An and Fengxi Su and Kim, {Betty Y S} and Qiang Liu and Lisa Jacobs",
year = "2015",
doi = "10.1007/s10549-015-3315-5",
language = "English (US)",
volume = "150",
pages = "439--445",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Elevated risks of subsequent endometrial cancer development among breast cancer survivors with different hormone receptor status

T2 - a SEER analysis

AU - Liu, Jieqiong

AU - Jiang, Wen

AU - Mao, Kai

AU - An, Yi

AU - Su, Fengxi

AU - Kim, Betty Y S

AU - Liu, Qiang

AU - Jacobs, Lisa

PY - 2015

Y1 - 2015

N2 - Estrogen receptor (ER)-positive breast cancer patients treated with tamoxifen are known to have an elevated risk of subsequent endometrial cancer. However, it is unclear if ER-negative patients also have a higher risk of endometrial cancer. This population-based study aims to evaluate whether breast cancer patients with distinctive ER and PR status possess differential risks in developing delayed endometrial malignancy. Data were obtained from the Surveillance, Epidemiology, and End Results program (1992–2009). Standardized incidence ratio (SIR) was calculated as the observed cases of endometrial cancers among breast cancer survivors compared with the expected cases in the general population. Data were stratified by latency periods, race, age, and calendar year of breast cancer diagnosis. We identified 2044 patients who developed a second primary endometrial cancer among 289,933 breast cancer survivors. The overall SIRs for subsequent endometrial cancers were increased in all of the four subtypes (ER+PR+, ER+PR−, ER−PR+, and ER−PR−) of breast cancer. SIR was increased for all latency periods except for the initial 6–11 months after breast cancer diagnosis. Stratifying by age of diagnosis, elevated SIRs in all ER/PR groups were statistically significant among patients diagnosed with breast cancer after the age of 40. Demographically, non-Hispanic whites had increased SIRs in all subtypes of breast cancer, while Hispanic whites had no statistically elevated SIRs. Here we showed that patients with invasive breast cancer have a higher risk of developing subsequent endometrial cancer regardless of ER or PR status. The increased risk among hormone receptor-negative breast cancer survivors raises concerns whether common etiological factors among these breast cancer subtypes increase the susceptibility to develop endometrial cancer. Lower threshold for routine endometrial cancer surveillance may be warranted.

AB - Estrogen receptor (ER)-positive breast cancer patients treated with tamoxifen are known to have an elevated risk of subsequent endometrial cancer. However, it is unclear if ER-negative patients also have a higher risk of endometrial cancer. This population-based study aims to evaluate whether breast cancer patients with distinctive ER and PR status possess differential risks in developing delayed endometrial malignancy. Data were obtained from the Surveillance, Epidemiology, and End Results program (1992–2009). Standardized incidence ratio (SIR) was calculated as the observed cases of endometrial cancers among breast cancer survivors compared with the expected cases in the general population. Data were stratified by latency periods, race, age, and calendar year of breast cancer diagnosis. We identified 2044 patients who developed a second primary endometrial cancer among 289,933 breast cancer survivors. The overall SIRs for subsequent endometrial cancers were increased in all of the four subtypes (ER+PR+, ER+PR−, ER−PR+, and ER−PR−) of breast cancer. SIR was increased for all latency periods except for the initial 6–11 months after breast cancer diagnosis. Stratifying by age of diagnosis, elevated SIRs in all ER/PR groups were statistically significant among patients diagnosed with breast cancer after the age of 40. Demographically, non-Hispanic whites had increased SIRs in all subtypes of breast cancer, while Hispanic whites had no statistically elevated SIRs. Here we showed that patients with invasive breast cancer have a higher risk of developing subsequent endometrial cancer regardless of ER or PR status. The increased risk among hormone receptor-negative breast cancer survivors raises concerns whether common etiological factors among these breast cancer subtypes increase the susceptibility to develop endometrial cancer. Lower threshold for routine endometrial cancer surveillance may be warranted.

KW - ER/PR status

KW - First primary breast cancer

KW - Increased risk

KW - Subsequent endometrial cancer

UR - http://www.scopus.com/inward/record.url?scp=84925405676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925405676&partnerID=8YFLogxK

U2 - 10.1007/s10549-015-3315-5

DO - 10.1007/s10549-015-3315-5

M3 - Article

C2 - 25764167

AN - SCOPUS:84925405676

VL - 150

SP - 439

EP - 445

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -