Ph.D. Program in Translational Medicine, National Chung-Hsing University, Taichung, Taiwan, Republic of China.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
PLoS One. 2019 Sep 19;14(9):e0222860. doi: 10.1371/journal.pone.0222860. eCollection 2019.
Breast cancer is one of the most common malignancies among women. However, there remains no consensus in current literature on the incidence of autoimmune diseases among breast cancer patients. The purpose of this study was to evaluate the risks of major autoimmune diseases (MAD) including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren's syndrome (SS) and dermatomyositis (DMtis)/polymyositis (PM) in female breast cancer patients.
Using the Taiwanese National Health Insurance Research Database (NHIRD) records from 2003 to 2013, we identified newly-diagnosed female breast cancer patients and randomly selected females without breast cancer in the period 2007 to 2013 into a control group. We matched the two cohorts using a 1:4 ratio based on age, and the year of index date for comparison of the risk of major autoimmune diseases. We estimated and compared the relative risks of autoimmune diseases in female breast cancer patients and females without breast cancer.
A total of 54,311 females with breast cancer and 217,244 matched females without breast cancer were included in this study. For SLE, the incidence rates were 2.3 (breast cancer group) vs. 10.0 (control group) per 100,000 women years; for RA rates were 19.3 (breast cancer group) vs. 42.7 (control group) per 100,000 women years; and for SS rates were 20.5 (breast cancer group) vs. 38.2 (control group) per 100,000 women years. After adjusting for potential confounders, the hazard ratios (95% confidence intervals) for female breast cancer patients vs. control group were 0.04 (0.01-0.24) for SLE; 0.03 (0.02-0.04) for RA; and 0.21 (0.09-0.48) for SS.
Female breast cancer patients had lower risks of SLE, RA and SS when compared to female individuals without breast cancer. However, there was no significant difference in the risk of developing DMtis/PM between both groups.
乳腺癌是女性中最常见的恶性肿瘤之一。然而，目前文献中对于乳腺癌患者自身免疫性疾病的发病率仍没有共识。本研究旨在评估女性乳腺癌患者发生重大自身免疫性疾病（MAD）的风险，包括系统性红斑狼疮（SLE）、类风湿关节炎（RA）、干燥综合征（SS）和皮肌炎/多发性肌炎（DMtis/PM）。
我们使用 2003 年至 2013 年的台湾全民健康保险研究数据库（NHIRD）的记录，确定了新诊断的女性乳腺癌患者，并在 2007 年至 2013 年期间随机选择了无乳腺癌的女性作为对照组。我们基于年龄，采用 1:4 的比例将两组进行匹配，以比较重大自身免疫性疾病的风险。我们估计并比较了女性乳腺癌患者和无乳腺癌女性发生自身免疫性疾病的相对风险。
本研究共纳入了 54311 名女性乳腺癌患者和 217244 名匹配的无乳腺癌女性。SLE 的发病率为 2.3（乳腺癌组）/100000 妇女年，10.0（对照组）/100000 妇女年；RA 的发病率为 19.3（乳腺癌组）/100000 妇女年，42.7（对照组）/100000 妇女年；SS 的发病率为 20.5（乳腺癌组）/100000 妇女年，38.2（对照组）/100000 妇女年。调整潜在混杂因素后，与对照组相比，女性乳腺癌患者的危险比（95%置信区间）分别为 SLE：0.04（0.01-0.24）；RA：0.03（0.02-0.04）；SS：0.21（0.09-0.48）。
与无乳腺癌的女性个体相比，女性乳腺癌患者发生 SLE、RA 和 SS 的风险较低。然而，两组间发生 DMtis/PM 的风险无显著差异。
