Impact of autoimmune diseases on outcome of patients with early breast cancer
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Carmen Criscitiello1, Vincenzo Bagnardi2,3, Angela Esposito1, Lucia Gelao1, Barbara Santillo2, Giulia Viale1, Nicole Rotmensz2, Aron Goldhirsch1,4, Giuseppe Curigliano1
1Division of Experimental Therapeutics, Istituto Europeo di Oncologia, Milano, Italy
2Division of Epidemiology and Biostatistics, Istituto Europeo di Oncologia, Milano, Italy
3Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milano, Italy
4Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy
Giuseppe Curigliano, email: [email protected]
Keywords: autoimmunity, early breast cancer, endocrine therapy, clinical outcome, immunology
Received: February 11, 2016 Accepted: May 28, 2016 Published: June 13, 2016
Our aim was to analyze the impact of a concurrent autoimmune disease on outcome of patients with early breast cancer. We reviewed medical charts of patients with a diagnosis of autoimmune diseases (AD) among a population of 17.153 cases. We categorized ADs as endocrine, rheumatic, systemic, neurological diseases and vasculitis. For each patient in the study group, we matched 2 patients. The events to determine overall survival (OS) and disease free survival (DFS) were identified from follow-up data. We identified 279 (1.62%) patients with early breast cancer and concurrent ADs. The median follow-up was 7.0 years. The 10-year OS rate was 86% (95% CI, 80% to 91%) in the study group and 90% (95% CI, 86% to 93%) for the control group (p = 0.011). In patients with ER positive/HER2 negative subtype a worse OS was observed in the study group when compared to the control group (p = 0.0046); this difference remained statistically significant when the analysis was restricted to breast cancer mortality (p = 0.045). The 10-year DFS rate was 69% (95% CI, 61% to 76%) in the study group and 72% (95% CI, 66% to 77%) for the control group (p = 0.22). Autoimmunity at diagnosis of early breast cancer is associated with worse survival.
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