| 1. |
- H., Olsson, et al.
(författare)
-
Tamoxifen treated patients have a better survival than patients treated with aromatase inhibitors - A population based registry study in Sweden
- 2015
-
Ingår i: Cancer Research. - 0008-5472. ; 75:9 Suppl
-
Konferensbidrag (refereegranskat)abstract
- Background. Randomised trials suggest that therapy with aromatase inhibitors improves survival in breast cancer compared with tamoxifen therapy in postmenopausal cases with hormone receptor positive breast cancer. Whether these results from randomized studies transform into the general population is unknown. We have therefore compared survival for all breast cancer cases in Sweden diagnosed 2000-2008 (n=54406) who received adjuvant antihormonal therapy. Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women's antihormonal therapy was gathered from the Swedish Prescription Registry (22213 women were on antihormonal therapy). Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. The breast cancer death and overall death have been calculated and the survival was compared between tamoxifen and aromatase inhibitor treated breast cancer patients. Analyses were adjusted for TNM-stage and age at diagnosis and restricted to women aged 50 and above. Results. Patients being treated with tamoxifen had a better breast cancer prognosis compared with aromatase inhibitor treated patients (HR 0.54, 95%CI 0.48-0.61). Restricting the analysis to stage 1 disease confirmed a better prognosis for tamoxifen treated women (HR 0.48, 95%CI 0.34-0.66). A better prognosis could be seen in all age strata studies, 50-60.61-70.71-90. The findings for overall survival gave similar results. Conclusion .This population based observational study show that women treated with aromatase inhibitors have a worse overall and breast cancer specific survival compared with tamoxifen treated women regardless of age and tumor stage.
|
|
| 2. |
- H., Olsson, et al.
(författare)
-
Worse breast cancer prognosis in insulin treated diabetic patients - A population based registry study in Sweden
- 2015
-
Ingår i: Cancer Research. - 0008-5472. ; 75:9 Suppl
-
Konferensbidrag (refereegranskat)abstract
- Background. Diabetes may be linked to incidence of different tumor diseases and prognosis through various mechanisms such as the disease itself, hyperglycemia, obesity and anti-diabetes therapy. Material and methods. The study includes all women with BC diagnosed in Sweden between 2000 through 2008 (n=54406). The women had no previous cancer diagnosis during the period of 1958-1999. Dates of birth, BC diagnosis and TNM-stage where directly extracted from the cancer registry. The women's anti-diabetes therapy was gathered from the Swedish Prescribed Drug Registry. Information regarding the cause of death and date of death was obtained from the Cause of Death Registry and tbe Swedish Population Register up until the 31st of December 2012 and 31st of December 2013 respectively. Analyses have been restricted to patients receiving insulin therapy (n=2463) and their breast cancer prognosis has been calculated in comparison with breast cancer patients without diabetes. All analyses were adjusted for TNM-stage and age at diagnosis. Results. Patients with insulin treated diabetes had a worse prognosis compared with other women with breast cancer (HR 1.7, 95%CI 1.5-2.0). The worse prognosis could be seen both for patients with ER+ and ER- tumors. The worst prognosis was seen for patients treated with NPH insulins (HR 2.8, 95% CI 2.4-3.3) while patients treated with long-acting insulin analogs had an intermediate prognosis (HR 1.6, 95% CI 1.2-2.2). Those women treated with NPH insulins and metformin had a slightly worse prognosis (HR 1.4, 95% CI 1.0-1.8). The results for breast cancer specific survival and total survival were similar. Conclusion. Our results imply that insulin treated breast cancer patients have a worse survival compared with other women with breast cancer regardless of tumor stage. Metformin therapy may partially counteract the association.
|
|
