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Reduced Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens

Reduced Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens. Rapiti E et al. SABCS 2009;Abstract 35. Introduction.

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Reduced Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens

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  1. Reduced Lung Cancer Mortality Risk Among Breast Cancer Patients Treated With Anti-Estrogens Rapiti E et al. SABCS 2009;Abstract 35.

  2. Introduction • Women in the post-intervention period of the Women’s Health Initiative (WHI) trial who were assigned to combined hormone replacement therapy had a higher risk of cancer compared to those on placebo (JAMA 2008;299:1036). • Post-hoc analysis of the WHI trial demonstrated increased lung cancer mortality in women administered postmeno-pausal hormone replacement therapy of estrogen with progesterone versus placebo (Lancet 2009;374:1243). • 73 (0.11%) versus 40 (0.06%) deaths (hazard ratio=1.71, p=0.01) • Current study objective: • Assess if anti-estrogen therapy in patients with breast cancer is associated with a decreased lung cancer mortality risk. Rapiti E et al. SABCS 2009;Abstract 35.

  3. Methods • Study group of 6,655 patients diagnosed with breast cancer between 1980 to 2003 were identified from the Geneva Cancer Registry. • Patients having received anti-estrogens: 3,066 (46%) • Lung cancer incidence and mortality were followed until December 31, 2007, and were compared to age-, sex- and period-adjusted population rates using: • Standardized incidence ratios (SIRs) • Standardized mortality ratios (SMRs) • Subgroup analyses performed by period and smoking history. • Prior to 1990, women were less likely to have been administered anti-estrogen therapy, and related data on smoking history were limited. Rapiti E et al. SABCS 2009;Abstract 35.

  4. Smoking History of Study Population Versus General Female Population *Enquête sur la Consommation de Tabac en Suisse. Rapport 2001/2002. Zurich University 2003. Rapiti E et al. SABCS 2009;Abstract 35.

  5. Risk of Developing Lung CancerAfter Breast Cancer *Age-standardized (Geneva population distribution) incidence rates per 100,000 person-years. Rapiti E et al. SABCS 2009;Abstract 35.

  6. Risk of Death From Lung CancerAfter Breast Cancer *Age-standardized (Geneva population distribution) mortality rates per 100,000 person-years. Rapiti E et al. SABCS 2009;Abstract 35.

  7. Conclusions • Patients treated with anti-estrogens for breast cancer have a significantly reduced risk of death from lung cancer compared to the general population. • Residual confounding cannot be excluded due to the observational nature of the study. • This study further supports the hypothesis that estrogen plays a role in lung cancer prognosis. Rapiti E et al. SABCS 2009;Abstract 35.

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