Breast cancer in systemic lupus

Research output: Contribution to journalArticlepeer-review

Authors

  • S Bernatsky
  • R Ramsey-Goldman
  • M Petri
  • M B Urowitz
  • D D Gladman
  • P F Fortin
  • E Ginzler
  • J Romero-Diaz
  • C Peschken
  • S Jacobsen
  • J G Hanly
  • O Nived
  • E H Yelin
  • D Isenberg
  • A Rahman
  • S-C Bae
  • L Joseph
  • T Witte
  • G Ruiz-Irastorza
  • C Aranow
  • D Kamen
  • G Sturfeldt
  • W D Foulkes
  • J E Hansen
  • Y St Pierre
  • P Chrétien Raymer
  • B Tessier-Cloutier
  • A E Clarke

Colleges, School and Institutes

External organisations

  • McGill University
  • 3 Feinberg School of Medicine, Northwestern University, Chicago, USA.
  • 4 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, USA.
  • 5 Center for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital and University of Toronto, Toronto, Canada.
  • 6 Division of Rheumatology, Centre de recherche du CHU de Québec-Université Laval, Quebec City, Canada.
  • 7 State University of New York-Downstate Medical Center, New York, USA.
  • 8 Instituto Nacional de Ciencias Medicas y Nutrición, Mexico City, Mexico.
  • 9 University of Manitoba, Winnipeg, Canada.
  • 10 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • 11 Division of Rheumatology, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada.
  • 13 Department of Rheumatology, Institution of Clinical Sciences, Lund University Hospital, Lund, Sweden.
  • 14 Department of Medicine, University of California, San Francisco, USA.
  • University College London
  • 16 The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea.
  • 17 Department of Clinical Immunology, Hannover Medical School, Hannover, Germany.
  • 18 Autoimmune Diseases Research Unit, Department Of Internal Medicine, Hospital Universitario Cruces, University Of The Basque Country, Bizkaia, Spain.
  • 19 Feinstein Institute for Medical Research, New York, USA.
  • 20 Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, USA.
  • 22 Department of Therapeutic Radiology, Yale School of Medicine, New Haven, USA.
  • 2 Division of Clinical Epidemiology, Research Institute of the McGill University Health Center, Montreal, Canada.
  • 23 Department of Anatomical Pathology, University of British Colombia, Vancouver, Canada.
  • University of Calgary

Abstract

Objective There is a decreased breast cancer risk in systemic lupus erythematosus (SLE) versus the general population. We assessed a large sample of SLE patients, evaluating demographic and clinical characteristics and breast cancer risk. Methods We performed case-cohort analyses within a multi-center international SLE sample. We calculated the breast cancer hazard ratio (HR) in female SLE patients, relative to demographics, reproductive history, family history of breast cancer, and time-dependent measures of anti-dsDNA positivity, cumulative disease activity, and drugs, adjusted for SLE duration. Results There were 86 SLE breast cancers and 4498 female SLE cancer-free controls. Patients were followed on average for 7.6 years. Versus controls, SLE breast cancer cases tended to be white and older. Breast cancer cases were similar to controls regarding anti-dsDNA positivity, disease activity, and most drug exposures over time. In univariate and multivariate models, the principal factor associated with breast cancers was older age at cohort entry. Conclusions There was little evidence that breast cancer risk in this SLE sample was strongly driven by any of the clinical factors that we studied. Further search for factors that determine the lower risk of breast cancer in SLE may be warranted.

Details

Original languageEnglish
Pages (from-to)311-315
Number of pages5
JournalLupus
Volume26
Issue number3
Early online date29 Sep 2016
Publication statusPublished - Mar 2017