TY - JOUR
T1 - Diabetes and other comorbidities in breast cancer survival by race/ethnicity
T2 - The California breast cancer survivorship consortium (CBCSC)
AU - Wu, Anna H.
AU - Kurian, Allison W.
AU - Kwan, Marilyn L.
AU - John, Esther M.
AU - Lu, Yani
AU - Keegan, Theresa H
AU - Gomez, Scarlett Lin
AU - Cheng, Iona
AU - Shariff-Marco, Salma
AU - Caan, Bette J.
AU - Lee, Valerie S.
AU - Sullivan-Halley, Jane
AU - Tseng, Chiu Chen
AU - Bernstein, Leslie
AU - Sposto, Richard
AU - Vigen, Cheryl
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Methods: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. Results: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; Pinteraction = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (Pinteraction = 0.09). Conclusion: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. Impact: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.Background: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in nonwhite populations.
AB - Methods: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. Results: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; Pinteraction = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (Pinteraction = 0.09). Conclusion: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. Impact: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.Background: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in nonwhite populations.
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U2 - 10.1158/1055-9965.EPI-14-1140
DO - 10.1158/1055-9965.EPI-14-1140
M3 - Article
C2 - 25425578
AN - SCOPUS:84922749733
VL - 24
SP - 361
EP - 368
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 2
ER -