title: Autoimmune diseases and hypersensitivities improve the prognosis in ER-negative breast cancer.
abstract: BACKGROUND
  Breast cancer (BC) is one of the leading causes of death among women worldwide. Immunostimulatory treatment has increasingly been used as adjuvant therapy in the last few years, in patients with melanoma and other cancer forms, often with an induction of autoimmunity as a consequence of a successful treatment. We aimed at investigating if coexisting autoimmune diseases (AD) or hypersensitivities (HS) similarly to the side effects of immunostimulatory treatment resulted in a better overall survival, compared to patients without these disorders.
  
  
  METHODS
  The patient material used was a consecutive clinical material consisting of 1705 patients diagnosed with BC between 1980 and 2010 in Sweden. The patients were stratified according to coexisting AD, HS or lack of both. Overall survival was calculated using Kaplan-Meier and the Cox proportional hazard model.
  
  
  RESULTS
  Our main finding was that BC patients with estrogen receptor (ER) negative tumors together with preexisting AD or HS had a statistically significant better overall survival (HR=0.53; 95% CI= 0.30-0.96) compared to patients without. Premenopausal BC patients with a coexistence of AD or HS had a better overall survival, but this was not statistically significant.
  
  
  CONCLUSIONS
  For patients with premenopausal or ER-negative BC, coexistence with AD or HS was associated with a better overall survival. Although these findings require validation, and the mechanisms responsible need to be found, they hint to possible new treatment strategies for BC, especially for those with ER-negative tumors and potentially for premenopausal patients.
authors.affiliation: Department of Cancer Epidemiology, Skåne University Hospital Lund, Klinikgatan 22, Lund, 221 85 Sweden ; Department of Cancer Epidemiology, Skåne University Hospital Lund, Klinikgatan 22, Lund, 221 85 Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Einefors
authors.forename: Ulrika
authors.initials: U
authors.lastname: Kogler
authors.forename: Carolina
authors.initials: C
authors.lastname: Ellberg
authors.forename: Håkan
authors.initials: H
authors.lastname: Olsson
keywords: Autoimmune diseases; Breast cancer; ER-negative; Hypersensitivities; Immunostimulatory therapy; Premenopausal