Breast Cancer in Systemic Lupus ErythematosusTessier Cloutier B.a · Clarke A.E.a · Ramsey-Goldman R.b · Wang Y.a · Foulkes W.c · Gordon C.d · Hansen J.E.e · Yelin E.f · Urowitz M.B.g · Gladman D.g · Fortin P.R.h · Wallace D.J.i · Petri M.j · Manzi S.k · Ginzler E.M.l · Labrecque J.a · Edworthy S.m · Dooley M.A.n · Senécal J.L.o · Peschken C.A.p · Bae S.C.q · Isenberg D.r · Rahman A.r · Ruiz-Irastorza G.s · Hanly J.G.t · Jacobsen S.u · Nived O.v · Witte T.w · Criswell L.A.x · Barr S.G.m · Dreyer L.y · Sturfelt G.v · Bernatsky S.a · Systemic Lupus International Collaborating Clinics (SLICC)
aDivision of Clinical Epidemiology, McGill University Health Centre, Montreal, Que., Canada; bNorthwestern University Feinberg School of Medicine, Chicago, Ill., USA; cLady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Que., Canada; dCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; eDepartment of Therapeutic Radiology, Yale School of Medicine, New Haven, Conn., and fDepartment of Medicine, University of California, San Francisco, Calif., USA; gService de Rheumatologie, Toronto Western Hospital, Toronto, Ont., and hUniversité de Laval, Quebec, Que., Canada; iCedars-Sinai Medical Center/David Geffen School of Medicine at UCLA, West Hollywood, Calif., jJohns Hopkins University School of Medicine, Baltimore, Md., kWest Penn Allegheny Health System, Allegheny General Hospital, Pittsburgh, Pa., and lDownstate Medical Center, State University of New York, Brooklyn, N.Y., USA; mUniversity of Calgary, Calgary, Alta, Canada; nUniversity of North Carolina at Chapel Hill, Chapel Hill, N.C., USA; oDivision of Rheumatology, University of Montreal Hospital Center, Montreal, Que., and pUniversity of Manitoba, Winnipeg, Man., Canada; qDepartment of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea; rDepartment of Rheumatology, Faculty of Medicine, University College London, London, UK; sRheumatic Diseases Research Unit, Department of Medicine, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain; tDalhousie University and Capital Health, Halifax, N.S., Canada; uRigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; vLund University Hospital, Lund, Sweden; wHannover Medical School, Medicine, Hannover, Germany; wRosalind Russell Medical Research Center for Arthritis, University of California, San Francisco, Calif., USA;yDepartment of Rheumatology, Rigshospitalet and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
Objective: Evidence points to a decreased breast cancer risk in systemic lupus erythematosus (SLE). We analyzed data from a large multisite SLE cohort, linked to cancer registries. Methods: Information on age, SLE duration, cancer date, and histology was available. We analyzed information on histological type and performed multivariate logistic regression analyses of histological types according to age, SLE duration, and calendar year. Results: We studied 180 breast cancers in the SLE cohort. Of the 155 cases with histology information, 11 were referred to simply as ‘carcinoma not otherwise specified'. In the remaining 144 breast cancers, the most common histological type was ductal carcinoma (n = 95; 66%) followed by lobular adenocarcinoma (n = 11; 8%), 15 cancers were of mixed histology, and the remaining ones were special types. In our regression analyses, the independent risk factors for lobular versus ductal carcinoma was age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.14] and for the ‘special' subtypes it was age (OR 1.06, 95% CI 1.01-1.10) and SLE duration (OR 1.05, 95% CI 1.00-1.11). Conclusions: Generally, up to 80% of breast cancers are ductal carcinomas. Though our results are not definitive, in the breast cancers that occur in SLE, there may be a slight decrease in the ductal histological type. In our analyses, age and SLE duration were independent predictors of histological status.
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