Affiliation:
1. Department of Internal Medicine Case Western Reserve University and University Hospitals Seidman Cancer Center Cleveland Ohio USA
2. Case Western Reserve University Cleveland Ohio USA
3. Department of Population and Quantitative Health Sciences Case Western Reserve University Cleveland Ohio USA
4. Case Western Reserve University and University Hospitals Seidman Cancer Center Cleveland Ohio USA
5. Department of Pathology Case Western Reserve University and University Hospitals Seidman Cancer Center Cleveland Ohio USA
6. Division of Hematology and Oncology Case Western Reserve University and University Hospitals Seidman Cancer Center Cleveland Ohio USA
Abstract
AbstractBackgroundPatients with certain autoimmune conditions are at a reduced risk of developing breast cancer compared to the general population. Despite this, little is known about outcomes in patients with breast cancer who have a concurrent autoimmune diagnosis.MethodsThis study compared differences in outcomes between women with breast cancer who had or did not have an autoimmune diagnosis. The SEER‐Medicare databases (2007–2014) were used to identify patients with breast cancer and diagnosis codes were used to identify those with an autoimmune disorder.ResultsThe studied autoimmune diseases had a prevalence of 27% among the 137,324 patients with breast cancer. Autoimmune disease was associated with significantly longer overall survival (OS) and significantly lower cancer‐specific mortality (CSM) among stage IV breast cancer patients (p < 0.0001). After controlling for the effects of age, race, chronic kideny disease, chemotherapy, and radiation therapy autoimmune disease was still predictive of improved OS (HR: 1.45, 95% CI: 1.35–1.55, p < 0.0001) and CSM (HR: 1.40, 95% CI: 1.29–1.5, p < 0.0001). By contrast, in patients with stage I–III breast cancer, the presence of an autoimmune diagnosis was associated with a lower OS (p < 0.0001, p < 0.0001, and p = 0.026, respectively), compared to patients without autoimmune disease.ConclusionsWe found a higher prevalence of rheumatoid arthritis, Crohn's disease, ulcerative colitis, and systemic lupus erythematosus in patients with breast cancer compared to age matched cohorts in the general population. The presence of an autoimmune diagnosis was associated with a lower OS in stages I–III breast cancer and improved OS and CSM in patients with stage IV disease. These results suggest that anti‐tumor immunity plays an important role in late stage breast cancer and could potentially be exploited to improve the effectiveness of immunotherapy.
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology
Cited by
1 articles.
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