TAILIEUCHUNG - Endometrial cancer survival after breast cancer in relation to tamoxifen treatment: Pooled results from three countries

The way in which a registry operates depends, inevitably, on local condi- tions and on the material resources available. Usually, the main sources of information of a population-based registry include: (1) information from treatment facilities, such as cancer centres and major hospitals (and some- times, if appropriate, private clinics, hospices, homes for the elderly and general practitioners); (2) information from diagnostic services, especially pathology departments, but also haematological, biochemical and immuno- logical laboratories, X-ray and ultrasound departments, and other imaging clinics; (3) death certificates from the death registration system (if they are available) | Jones et al. Breast Cancer Research 2012 14 R91 http content 14 3 R91 Breast Cancer RESEARCH RESEARCH ARTICLE Open Access Endometrial cancer survival after breast cancer in relation to tamoxifen treatment Pooled results from three countries 1 2 2 3 4 Michael E Jones Flora E van Leeuwen Wilhelmina E Hoogendoorn Marian JE Mourits Harry Hollema Hester van Boven5 Michael F Press6 Leslie Bernstein7 and Anthony J Swerdlow1 Abstract Introduction Tamoxifen is an effective treatment for breast cancer but an undesirable side-effect is an increased risk of endometrial cancer particularly rare tumor types associated with poor prognosis. We investigated whether tamoxifen therapy increases mortality among breast cancer patients subsequently diagnosed with endometrial cancer. Methods We pooled case-patient data from the three largest case-control studies of tamoxifen in relation to endometrial cancer after breast cancer 1 875 patients Netherlands 765 United Kingdom 786 United States 324 and collected follow-up information on vital status. Breast cancers were diagnosed in 1972 to 2005 with endometrial cancers diagnosed in 1978 to 2006. We used Cox proportional hazards survival analysis to estimate hazard ratios HRs and 95 confidence intervals CI . Results A total of 1 104 deaths occurred during on average years following endometrial cancer 32 attributed to breast cancer 25 to endometrial cancer . Mortality from endometrial cancer increased significantly with unfavorable non-endometrioid morphologies P International Federation of Gynaecology and Obstetrics staging system for gynecological malignancy FIGO stage P and age P . No overall association was observed between tamoxifen treatment and endometrial cancer mortality HR 95 CI to . Tamoxifen use for at least five years was associated with increased endometrial cancer mortality HR to . This association appeared to be due primarily to the excess of .

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