Abstract
Breast cancer is one of the most common malignancies among women. However, there remains no consensus in current literature on the incidence of autoimmune diseases among breast cancer patients. The purpose of this study was to evaluate the risks of major autoimmune diseases (MAD) including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren's syndrome (SS) and dermatomyositis (DMtis)/polymyositis (PM) in female breast cancer patients. Using the Taiwanese National Health Insurance Research Database (NHIRD) records from 2003 to 2013, we identified newly-diagnosed female breast cancer patients and randomly selected females without breast cancer in the period 2007 to 2013 into a control group. We matched the two cohorts using a 1:4 ratio based on age, and the year of index date for comparison of the risk of major autoimmune diseases. We estimated and compared the relative risks of autoimmune diseases in female breast cancer patients and females without breast cancer. A total of 54,311 females with breast cancer and 217,244 matched females without breast cancer were included in this study. For SLE, the incidence rates were 2.3 (breast cancer group) vs. 10.0 (control group) per 100,000 women years; for RA rates were 19.3 (breast cancer group) vs. 42.7 (control group) per 100,000 women years; and for SS rates were 20.5 (breast cancer group) vs. 38.2 (control group) per 100,000 women years. After adjusting for potential confounders, the hazard ratios (95% confidence intervals) for female breast cancer patients vs. control group were 0.04 (0.01-0.24) for SLE; 0.03 (0.02-0.04) for RA; and 0.21 (0.09-0.48) for SS. Female breast cancer patients had lower risks of SLE, RA and SS when compared to female individuals without breast cancer. However, there was no significant difference in the risk of developing DMtis/PM between both groups.
Highlights
Breast cancer is one of the most common malignancies among women
Female breast cancer patients had lower risks of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and s syndrome (SS) when compared to female individuals without breast cancer
Previous studies [2,3,4] have demonstrated that breast cancer patients showed an increased spontaneous expression of cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) on T lymphocytes in breast tissue and peripheral blood mononuclear cells, leading to impaired T cell activation
Summary
Breast cancer is one of the most common malignancies among women. In Taiwan, autoimmune diseases were three to four times more common in women than in men [1]. There remains no consensus on the incidence rates of autoimmune diseases among breast cancer patients. T cell activation is involved in the development of autoimmune diseases such as rheumatoid arthritis [5], systemic lupus erythematosus [6,7], Sjogren’s syndrome [8,9], dermatomyositis (DMtis) [10,11] and polymyositis (PM) [10,11]. There remains no consensus in current literature on the incidence of autoimmune diseases among breast cancer patients. The purpose of this study was to evaluate the risks of major autoimmune diseases (MAD) including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjogren’s syndrome (SS) and dermatomyositis (DMtis)/polymyositis (PM) in female breast cancer patients
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