Department of Pathology, Stony Brook University Medical Center, Stony Brook, NY, USA.
Int J Cancer. 2011 Feb 15;128(4):763-70. doi: 10.1002/ijc.25395.
A comparative study between endometrial serous carcinoma (ESC) and endometrial endometrioid carcinoma (EEC) was performed to determine whether a personal history of breast cancer is a risk factor for ESC in women aged ≤ 55 yr. Study subjects consisted of 348 women who were diagnosed with ESC and 830 comparison subjects who had EEC. Variables studied included age at diagnosis, a history of breast cancer, tamoxifen therapy, hormonal replacement therapy and smoking history. Overall, 19.4% of women with ESC had a history of breast cancer, which was significantly higher than that of 3% in comparison subjects. Among the study subjects, the incidence of a prior breast cancer was significantly higher in patients who were 55 yr of age or younger (41.5%) than those who were older than 55 yr (16%). The statistical significance of both of the aforementioned comparisons was independent of tamoxifen usage on multivariate analyses. The mean time interval between prior breast cancer and endometrial cancer was 92.5 mo (range 7-240 mo) in the study group and 79 mo (range 7-192 mo) in the comparison group. For the whole cohort and individual subgroups (ESC, EEC, ≤ 55 yr and >55 yr), a personal history of breast cancer did not adversely affect the patient outcomes, which was largely dependent on standard clinicopathologic parameters such as International Federation of Gynecology and Obstetrics stage, as has previously been demonstrated. These findings suggest that a personal history of breast cancer may be a significant risk factor for the development of ESC in women aged ≤ 55 yr. Further studies are needed to clarify the relationship between these two cancers in this age group and whether this increased risk is reflective of a genetic predisposition.
对子宫内膜浆液性癌(ESC)和子宫内膜内膜腺癌(EEC)进行了对比研究,以确定≤55 岁的女性中乳腺癌病史是否是 ESC 的危险因素。研究对象包括 348 名被诊断为 ESC 的女性和 830 名患有 EEC 的对照女性。研究的变量包括诊断时的年龄、乳腺癌病史、他莫昔芬治疗、激素替代治疗和吸烟史。总的来说,19.4%的 ESC 女性有乳腺癌病史,明显高于对照组的 3%。在研究对象中,年龄≤55 岁的患者(41.5%)先前患有乳腺癌的比例明显高于年龄>55 岁的患者(16%)。在多变量分析中,上述两种比较的统计学意义均独立于他莫昔芬的使用。在研究组中,先前乳腺癌和子宫内膜癌之间的平均时间间隔为 92.5 个月(范围 7-240 个月),在对照组中为 79 个月(范围 7-192 个月)。对于整个队列和个体亚组(ESC、EEC、≤55 岁和>55 岁),乳腺癌病史并未对患者的预后产生不利影响,这主要取决于国际妇产科联合会(FIGO)分期等标准临床病理参数,如先前已经证明的那样。这些发现表明,乳腺癌病史可能是≤55 岁女性 ESC 发生的一个重要危险因素。需要进一步研究来阐明这一年龄组中这两种癌症之间的关系,以及这种风险增加是否反映了遗传易感性。