Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China; Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital, Changsha, People's Republic of China; Department of Breast Cancer Medical Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China; Central Laboratory, The Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, People's Republic of China.
Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China; Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital, Changsha, People's Republic of China; Department of Breast Cancer Medical Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China.
Clin Breast Cancer. 2018 Oct;18(5):e1149-e1163. doi: 10.1016/j.clbc.2018.04.009. Epub 2018 Apr 19.
Hormone receptor and human epidermal growth factor receptor 2 (HER2) status is important for breast cancer (BC) treatment. Previous studies have shown that the long-term treatment outcomes of BC are significantly impaired by the development of subsequent malignancies. Therefore, in the present study, we evaluated the effect of hormone receptor/HER2 status on subsequent malignancies in breast cancer survivors.
The Surveillance, Epidemiology, and End Results*Stat database (8.3.4) was used as the data source. We identified 535,941 female survivors with first primary BC through the database from 1973 to 2013. Of these patients, 23,964 had developed subsequent contralateral BC, 8398 had developed subsequent uterine or ovarian cancer, and 7435 patients had developed subsequent colorectal cancer.
Estrogen receptor (ER) positivity and progesterone receptor (PR) positivity were significant protective factors against subsequent BC and ovarian cancer. However, ER BC and PR BC were significant risk factors for subsequent colorectal cancer. In addition, HER2 status demonstrated a marginally significant risk effect for subsequent thyroid cancer. Triple-negative (ER/PR/HER2) status showed elevated risk of subsequent breast, ovarian, and uterine cancer.
ER/PR patients were less likely develop secondary breast and ovarian malignancies, possibly owing to advancements in anti-ER/PR treatment. However, ER/PR patients were more likely to develop colorectal cancer, suggesting a potential screening necessity for these patients.
激素受体和人表皮生长因子受体 2（HER2）状态对乳腺癌（BC）的治疗至关重要。先前的研究表明，BC 后续恶性肿瘤的发展显著损害了长期的治疗效果。因此，在本研究中，我们评估了激素受体/HER2 状态对乳腺癌幸存者后续恶性肿瘤的影响。
使用监测、流行病学和最终结果*Stat 数据库（8.3.4）作为数据源。我们通过数据库从 1973 年到 2013 年确定了 535,941 名患有首次原发性 BC 的女性幸存者。在这些患者中，有 23,964 例发生了后续对侧 BC，8398 例发生了后续子宫或卵巢癌，7435 例发生了后续结直肠癌。
雌激素受体（ER）阳性和孕激素受体（PR）阳性是对侧 BC 和卵巢癌的显著保护因素。然而，ER 阳性 BC 和 PR 阳性 BC 是结直肠癌的显著危险因素。此外，HER2 状态对随后的甲状腺癌显示出边缘显著的风险效应。三阴性（ER/PR/HER2）状态显示出随后乳腺癌、卵巢癌和子宫癌的风险增加。
ER/PR 患者发生继发性乳腺和卵巢恶性肿瘤的可能性较小，这可能是由于抗 ER/PR 治疗的进步。然而，ER/PR 患者更有可能发生结直肠癌，这表明这些患者可能需要进行潜在的筛查。
